Certified Patient Account Representative - Chambersburg - Days

Full time (40 hours weekly)
M-F, Flex option of 6a-2:30p, 6:30a-3p, 7a-3:30p, 7:30a-4p, 8a-4:30p, or 8:30a-5p

Position Function:   Under the direction of the Assistant Patient Account Manager, is responsible for the billing of Medicare, Medical Assistance, Blue Cross, Highmark Blue Shield, Tricare, commercial insurance, managed care, auto, workers compensation and other payors  to the appropriate intermediary or third party payor.  Receives and reviews direct pay accounts, past due bills, and follow-up documents for all direct pay accounts of a specified collection group.  Contacts payors and patients to secure payments or arrange alternative settlement plans.

Essential Functions and Responsibilities
       Unit Based Essential Functions and Responsibilities

 

Core Values:  Service, Integrity, Compassion
1.   Demonstrates service excellence and patient and family centered care by showing respect, honesty, fairness and a positive attitude toward all customers.
2.   Maintains confidentiality.
3.   Demonstrates dependability, to include attendance and punctuality.
4.   Is accountable - takes initiative and ownership of issues. 
5.   Displays a professional demeanor.  Represents hospital in a positive way. Has a compassionate working relationship with patients and families.
6.   Assumes personal responsibility for 2-way communication.  Communicates and listens effectively with patients, families, coworkers, other departments, physicians/providers and community.
7.   Supports coworkers, initiatives and a patient and family centered philosophy; pitches in; does own part and helps others.
8.   Works to continuously improve work environment/processes (Performance Improvement). Demonstrates a patient and family centered focus when considering/developing improvement solutions.
9.   Represents willingness/enthusiasm to create, embrace and facilitate change.
10.   Develops self and others; supports a learning environment; leads by example. Encourages patients and families to give feedback and suggestions for improvement.
11.   Develops working relationships critical to the organization including patients, families, coworkers, other departments, physicians/providers and community.
12.   Encourages others by providing recognition and support.  

Technical Excellence
1.   Thinks critically; utilizes sound judgment; promptly reports potential risks.
2.   Maintains state of art knowledge of area of specialty, healthcare trends and practice, and populations served.
3.   Maintains a level of computer literacy appropriate to their role.
4.   Meets and maintains current all unit specific and organizational skills/competencies, certifications/licensures, as required.
5.   Completes hospital-required reviews, e.g. HIPAA, safety, health screening, care concerns, and others as assigned. 
6.   Adheres to National Patient Safety Goals.
 

Job Specifics
1.   Understands Payor Regulations as they apply to billing, cash payments and patient responsibilities.  Adheres to regulations.  Reports any activity suspected as non-compliant to the Compliance Hot Line.  Also, reports to Hot Line any situation where a person of influence has directed the employee to adopt a process suspected to be non-compliant.
2.   Establishes and maintains accuracy, integrity, and completeness in all records, reports, and claims issued in conjunction with responsibilities.
3.   Prioritizes workload at the beginning of shift so that important deadlines are met.  Informs Assistant Patient Account Manager of any problems which would prevent the timely completion of work.
4.   Handles all communication to patients, their agents, and Hospital agents with the highest regard for good customer service.  Treats all external customers with a high degree of respect.
5.   Attends scheduled departmental in-services and staff meetings to develop communication skills, learn new forms/procedures, etc.
6.   Participates in special projects conducted by the department or other area as workload permits.
7.   Participates in disaster and other emergency drills, M-1 disaster or evacuation.
8.   Understands and follows hospital fire and safety procedures for satellite facilities, knows personal role in case of fire.
9.   Maintains a neat, clean work area.  Communicates housekeeping needs as appropriate.
10.   Actively participates in the management of information either through a computerized fashion, manual or paper-based system.
11.   Split for each Sorts Biller Queue daily.  Identifies proper financial classification accounts.  Keys insurance changes to be made prior to final billing.
12.   Split for each Changes Collection Group, insurance information and updates statement information as appropriate, when pertinent information is received or on a daily basis.
13.   Verifies insurance coverage if app