Description

ESSENTIAL FUNCTIONS:

• Responsible for auditing the admission packets and for the verification of benefits along with all patient demographic information in the patient accounting system.

• Financial counseling of patients and/or guarantors and collecting any out of pocket (deductibles, copays, exhausted days, etc.). Provide information to the patient and/or guarantors regarding their benefits and financial obligations.

• Complete financial disclosure paperwork for patients that request assistance including verifying income and expenses.

• Complete adjustment forms for any charity or administrative adjustments for approval.

• Complete promissory notes for patients that request payment arrangements.

• Update daily the upfront collection log, charity log, and admin adjustment log. Review with BOD on a weekly basis.

• Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.

• Weekly reporting to BOD an overview of the week and participate in AR meetings.

• Gathers and interprets data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.

• Manage daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 30-40 accounts worked per day minimum.

• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.

• Call and status outstanding claims with third party payors.

• Review explanation of benefits to ascertain that claim processed and paid correctly.

OTHER FUNCTIONS:

• Performs other essential duties as assigned.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• High school diploma or equivalent required.

• Three or more years' experience in related field required.

• Extensive knowledge and understanding of Commercial Insurance and Medicare/Medicaid required.

• Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.

• Knowledge of office administration procedures with the ability to operate most standard office equipment.

• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.

• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.

• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.

• Self-motivated with strong organizational skills and superior attention to detail.

• Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.

• Capable of working within established policies, procedures and practices prescribed by the organization.

• English sufficient to provide and receive instructions/directions.

  PHYSICAL/MENTAL REQUIREMENTS:

• Must be able to perform essential functions listed on the job description, with or without reasonable accommodation.

• Must be able to sit and stand, intermittent 8 to 10 hours a day.

• Maintains regular and predictable attendance.

• Must be able to speak to medium sized audience with and without the use of a microphone.

• Must be able to use standard office equipment, including the telephone and computer keyboard.

• Continuously works under pressure of near 100% accuracy while meeting inflexible deadlines.

• Continuously utilizes manual/bi-manual dexterity, near vision, speech, and hearing.

• Frequently stands, walks, sits and utilizes eye/hand coordination and color definition.

• Occasionally reaches above shoulder, regularly required to lift and/or carry up to 20 lbs.

• Occasionally walks on uneven surfaces.

• Ability to travel up to 5% of the time, including flying and driving rental cars.

• To accommodate travel, must be able to transport own suitcases and computer estimated at 25 pounds.

  WORK CONDITIONS/HOURS

Normal hours are 8 a.m. – 5 p.m., Monday – Friday. However, schedules may vary in accordance with business necessity. Typical office working conditions.

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

Qualifications

Behaviors

Required

• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations

Required

• Goal Completion: Inspired to perform well by the completion of tasks

• Self-Starter: Inspired to perform without outside help

Education

Required

• High School/GED or better

Experience

Required

• 3 years: Commercial Insurance and Medicare/Medicaid

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)