Patient Account Specialist

Job Description

Job Description

Position Purpose:

The Collector is responsible for thorough and timely patient account follow up to ensure accurate accounts receivable reporting’ to ensure payments by primary and secondary payers and self-pay patients are accurate. The Collector will be responsible for daily generation of patient statements (or per facility schedule). The Collector will be responsible for answering patient calls and correspondence while providing timely, accurate, professional responses and resolution. The Collector will function within the Center’s policies and procedures. The Collector promotes a favorable image of the facility to the physicians and their offices, patients and families, vendors and the general public.

 

 

WORKING RELATIONSHIPS

 

As a representative of the facility, all comments, attitudes, actions, and behaviors have a direct affect on the Facility’s image and perceptions of quality service. Interaction with patient, families, physicians, referral sources affiliating schools, visitors, volunteers, co-workers, supervisors, vendors, etc., must be in a manner that is friendly, supportive, courteous, respectful, cooperative, and professional. This behavior should promote an atmosphere of teamwork, which is congruent with Facility standards and guidelines to promote positive relations.

 

POSITION REQUIREMENTS

 

 

Total Education, Vocational Training and Experience: High school graduation or equivalent.

 

One-year work experience in a healthcare setting to include a Physician Office, Outpatient, and acute care setting is preferred. Computer and office equipment skills required.

 

JOB REQUIREMENTS:

 

A. Skills and Abilities:

 

1. Primary functions are credit balance management, patient balance resolution and non-patient (insurance) resolution.

 

2. Accurate and timely follow up and resolution for all accounts receivables.

 

3. Meeting and maintaining cash collection metrics and goals.

 

4. Maximized facility reimbursement.

 

5. Understands each payer contract and will utilize the ensure payments received are correct.

 

6. Understands the Explanation of Benefits received from any payer.

 

7. Works closely with payer provider relations representatives.

 

8. Has thorough knowledge of allowable procedures

 

9. Handles contracted and non-contracted; HMO, PPO, EPO, POS, Workers compensation, self- pay and third-party reimbursement issues.

 

10. Effectively and independently handles second level reimbursement issues, contracted and non-contracted denials for services before and after procedures.

 

11. Works all denials ad corrected claims collaborating with the biller and/or Business Office Coordinator, insurance payers and/or patients on past due accounts.

 

12. Follow center policies, procedures and best practices for resolution and reassignment of accounts.

 

13. Possess basic knowledge of medical terminology and health insurance billing.

 

14. Have ability to communicate effectively with patients, physicians, and other teammates.

 

B. Clinical Quality

 

1. Communicates patient information to assure confidentiality and continuity of care

 

a. Documents all patient information according to established standards of care, policies and procedures.

 

b. Discusses patient information with other health team members in an appropriate environment

 

2. Interacts with all patients, families, visitors and fellow employees in a mature, responsible manner to ensure a positive and professional facility environment.

 

a. Displays a caring and responsive attitude and conducts all activities respecting patient, family and employee rights and expectations

 

b. Maintains confidentiality of all facility and patient information as required by facility policy

 

3. Considers age specific needs in communication.

 

 

C. Teamwork/Accountability/ Integrity:

 

1. Utilizes time effectively

 

2. Follows established facility policies and procedures with regard to attendance.

 

a. Maintains attendance according to guidelines and policy established by facility.

 

b. Adheres to tardiness policy.

 

c. Provides notification for unscheduled absences or tardiness in accordance with established departmental procedures as noted by supervisor.

 

d. Requests scheduled time off according to procedure as noted by supervisor.

 

3. Completes all documentation to ensure the availability of accurate and up to date information in accordance with established standards.

 

4. Adheres to established facility safety requirements and procedures to ensure a safe working environment.

 

a. Demonstrates to competent usage of proper body mechanics in all activities.

 

b. Identifies potentially unsafe situations and notifies supervisor.

 

c. Completes all Teammate/patient event and variance documentation in a thorough and timely manner, as required by policy.

 

d. Demonstrates complete understanding of established emergency procedures for facility.

 

e. Practices infection prevention, standard precautions and universal precautions as instructed or trained.

 

f. Maintains work area and equipment in a neat, organized manner.

 

5. Completes appropriate financial management responsibilities.

 

a. Provides input regarding equipment or supply needs.

 

b. Completes patient charges in accordance with facility procedure and per facility policy.

 

c. Demonstrates sound cost containment techniques.

 

6. Assists with housekeeping tasks as necessary to provide a safe environment for patients, teammates, physicians, and guests.

 

7. Upholds and practices the principles and polices of Sovereign Healthcare

 

8. Performs all other duties as assigned by management.

 

 

D. Continuous Improvement:

 

1. Attends staff meetings and demonstrates review of minutes for any meetings missed.

 

2. Participates in scheduled performance appraisals and demonstrates dedication to ongoing performance improvement.

 

 

D. Service Excellence

 

1. Fosters a positive and professional facility environment by interacting with all persons in a considerate, helpful, and courteous manner and by participating as a team member.

 

a. Diffuses/resolves conflict by appropriately communicating with those involved.

 

b. Accepts constructive criticism and gives suggestions in a professional manner

 

c. Considers age specific needs in communication.

 

2. Maintains dress and appearance according to standards as observed by management.

 

3. Demonstrates the safe operation of equipment and machinery and follows procedures for reporting and correcting an unsafe situation

 

4. Strives to be professional, courteous, helpful and cooperative.

 

E. Attendance

 

Follows established policies and procedures with regard to attendance

 

1. Maintains attendance according to guidelines and policy established by facility

 

2. Adheres to tardiness policy.

 

3. Provides notification for unscheduled absences or tardiness in accordance with established departmental procedures as noted by supervisor.

 

F. Proficiency or Productivity Standards

 

ENVIRONMENTAL CONDITIONS: Indoors in climate-controlled environment. Patient care environment with potential exposure to unpleasant odors, to blood and body fluids which may carry infection, to infectious disease, and to chemical and electrical hazards.

Work is performed in an office environment. Involves frequent telephone contact with patients. Work may be stressful at times. Interaction with others is constant and interruptive.

 

PHYSICAL REQUIREMENTS: Ability to answer telephone; ability to sit for long periods of time; ability to lift 15 pounds; hand/ finger agility necessary to typing and computer use; good hearing, clear/ articulate speech, and visual acuity.

Work may require hand dexterity for telephone and office machine operation, stooping and bending to files and supplies, sitting for extended periods of time. Manual dexterity for using a computer keyboard. Ability to enter data into computer, files large amounts of paper, and use office equipment

Ability to use discretion in dealing with the public.