Patient Accounts Rep - Patient Financial Services - Full Time 8 hours Days (7:00AM to 3:30PM) (Non-Union, Non-Exempt)

• Attending seminars, as needed.
• Complete inquiry forms accurately and completely to expedite account resolution.
• Correct any errors promptly and accurately.
• Correct any errors promptly and have the claim resubmitted if needed.
• Displays professional commitment and supports the unit team by promoting unity and teamwork among coworkers by maintaining a positive attitude and positive working relationships.
• Handle incoming correspondence and returned mail on a timely basis.
• Identify late charges, obtain supporting documentation, update contractual adjustment on the account and have a corrected claim submitted to the insurance carrier in a timely manner.
• Maintain accurate and complete notes on the patient account note area within the current computer system.
• Maintain productivity report for accounts within assigned responsibility and submit to Customer Service Manager weekly or as requested.
• Meet or exceed productivity and monthly cash collection goals as assigned by Customer Service Manager.
• Negotiate payment arrangements.
• Obtain a completed charity application with all required documents from patients that apply for charity or our discount program.
• Obtain all necessary documentation from patient, insurance company, or third payer intermediary to ensure all accounts are being resolved according to established hospital guidelines.
• Obtain approvals per procedure guidelines for any adjustments.
• Prepare refund request and obtain supporting documentation for credit balance resolution per established guidelines.
• Prepare request form for account write-off or agency referral after appropriate follow-up activity has been performed and refer to Customer Service Manager or other assigned personnel for approval.
• Reduce outstanding dollars and number of accounts on a consistent basis.
• Report all collection and follow-up activities daily as requested by the Customer Service Manager.
• Resolve accounts within assigned responsibility per Account Receivables Summary Report using procedure guidelines (collection work list).
• Responsible for understanding and participating in the organization-wide Performance Improvement Program through orientation, education, departmental and interdepartmental quality control, performance improvement, and quality
• planning activities.
• Screen patients for potential Medi-Cal coverage or charity write-off, if not able to negotiate payment arrangements.
• Send appropriate form letters when necessary.
• Submit transactions (adjustments) as required to maintain an accurate patient account record on the computer system.
• Telephone patient/guarantor, insurance company or third-party intermediary to resolve account balances.
• Use the telephone as a primary tool in effective collection/follow-up activity.
• Verify the accuracy of the insurance payments and patient responsibility as stated in the Explanation of Benefits (EOB).

Education
Req
High School or equivalent

Work Experience
Req
Experience with Chart Maxx or other scanning systems.
Experience with Quadra Med/Affinity or other patient accounting software.
2-3 years' Experience in a health care environment.
Experience with Insurance (UB04) billing regulations; and electronic claims submission.

Knowledge, Skills and Abilities
Req
Must be able to operate 10-key calculator, type a minimum of 40 words per minute and other business machine operation experience.
Must present a professional image to patients and the community through telephone, personal contact, and/or written correspondence.
Responsible to perform, understand and demonstrate ability of all courses designated, within 90 days of hire for new employees and within 1 year of 2/12/2018 for current employees.
Current employees must successfully pass a competency test every two years from the original date completed.

Other Knowledge, Skills and Abilities

Pref

Knowledge of fair credit and collection practices.

Understanding of PPO/HMO and commercial insurance benefits and billing requirements.

Licenses/Certifications

Pref
Certified Patient Account Technician certificate.

• Notice of Non-discrimination
• Employment Equity
• Read USC’s Clery Act Annual Security Report
• USC is a smoke-free environment
• Digital Accessibility

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