Patient Financial Services Specialist II

Patient Accounting Specialist

Pay Range: $25.00 - $28.45

Performs a variety of patient accounting functions including insurance billing, self-pay billing, remit analysis & cash posting, accounts receivable management, claims follow up, charge validation and analysis, denials analysis & resolution and tasks to support the Consortium's month end close processes.

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it's a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.

Key Essential Functions and Accountabilities of the Job

• Validates changes and billing information.

  • Validates proper charge codes, billing, and adjudication of claims in accordance with standard federal, state, and private billing policies and reimbursement principles.
  • Stays current on changing payor-specific charging and billing rules.
  • Assists with other special projects related to billing/rebill projects.
  • Identifies, analyzes, and reconciles billing errors or omissions.

• Provides service to customers, answering questions and resolving issues.

  • Answers patient billing questions and takes necessary action to resolve the account.
  • Validates balance, bills and follows-up on patient self-pay accounts consistent with the Consortium's discount, bad debt and charity policies.
  • Locates and monitors delinquent patient self-pay accounts, notifies patients of delinquent accounts by mail or telephone, and arranges for debt repayment.
  • Collaborates with financial counselors to identify alternative funding sources for patients.

• Reconciles payments.

  • Logs all transactions posted to the organization's bank account into the cash log and allocates all monies to the appropriate EHR system or identifies as a general ledger transaction.
  • Balances all transactions posted to source system and daily batch deposits.
  • Researches and resolves un-applied cash and misapplied payment research requests.
  • Communicates effectively with the cash posting team and participates and contributes constructively to produce results in a cooperative effort to ensure that all funds are processed, scanned, and batched for posting within established service levels.

• Processes incoming mail.

  • Prints, scans, and organizes correspondence such as EOBs, letters, and denials.
  • Downloads back-up for clinic deposits in the PFS shared drive folders.
  • Logs denials and works closely with billing to ensure proper follow up.
  • Enters account history notes when necessary for billing team follow up.
  • Hands off other correspondence to proper staff for follow up.

• Facilitates insurance and patient refunds and ensures all back-up is scanned into refund log. Assists in communication of strategies or messages from senior leadership.

• Cash Posting & ERA Management: Accurately posts all cash, checks, credit cards, and electronically transferred funds to beneficiary and non-beneficiary accounts within 3 business days of cash deposit or escalate non-postable deposits for resolution.

  • Researches and resolves un-applied cash and misapplied payment research requests.
  • Balances all transactions posted to source system and daily batch deposits.
  • Deciphers Explanation of Benefits (EOB) and balances transfer money to the secondary insurance or patient liability.
  • Resolves rejected electronic transactions and assists with the identification and implementation of new payers for electronic transactions; posts incoming claim denials and work closely with the billing/denials team to document within denials log and ensure proper follow up and appeals.

Other Functions

• Participates in development and updating of organization procedures and update of forms and manuals.
• Performs a variety of general clerical duties and other routine functions.
• Other duties as assigned.

Additional Details:

Education, Certifications, and Licenses Required

• High school diploma or equivalent – required.
• Associates degree in related field – preferred
• Certified CRCR (HFMA-Medical), CRCS (AAHAM-Medical), or CDBS (ADCA-Dental). Current employee must be in good standing to qualify for employer-paid certification.

Experience Required

• Two years of experience in billing, collections and/or cash posting – required

Knowledge of

• Knowledge of hospital or clinic billing and follow up and medical terminology
• Knowledge of payor remittances and basic knowledge of CPT's, HCPCS, and Revenue Codes
• Knowledge of major insurance companies' billing policies to ensure compliance and insurance claim forms
• Knowledge of specific specialties within the hospital or clinic billing area
• Knowledge of reconciling and balancing of payments received against account receivables

Skills in

• Using a keyboard and 10-key
• Problem solving, decision making and detail orientation
• Verbal and written communication

Ability to

• Collaborate within cross-functional teams
• Work in a fast-paced setting

Position Information:

Work Shift: OT 8/40

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!