PATIENT ACCOUNT SPECIALIST I - PFS - Full Time - Days

Patient Account Specialist I - Full Time

Shift: 8:00am - 4:30pm

Job Description: 

PATIENT POPULATION:
The patient population served can be all patients, including geriatric, adult, adolescent, pediatric, and newborn. This also includes services which affect facility staff, physicians, visitors, vendors and the general public.

POSITION SUMMARY:
Under the direct supervision of the Manager of Patient Financial Services and Administrative Director of Revenue Cycle, the Patient Accounting Specialist I is responsible for billing and/or follow-up and maintenance methodologies of the Patient Accounts Receivable for the organization. The above should be carried out with the regulations and guidelines of Medicare, Medi-Cal and commercial insurance contracts.

Must be able to work normal/scheduled working hours to include Holidays, call-backs, weeknights, weekends, and on-call. Agrees to participate, as directed, in emergencies and community disasters during scheduled and unscheduled hours. As a designated disaster service worker you are required to assist in times of need pursuant to the California Emergency Services Act.
(Gov’t. Code §§ 3100, 3102)


Needs to recognize that they have an affirmative duty and responsibility for reporting perceived misconduct, including actual or potential violations of laws, regulations, policies, procedures, or this organization’s standards/code of conduct.

The employee shall work well under pressure, meet multiple and sometimes competing deadlines; and the incumbent shall at all times demonstrate cooperative behavior with colleagues and supervisors.


EDUCATION/TRAINING/EXPERIENCE:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent organization skills.

To perform this job successfully, an individual should be a high school graduate or equivalent with two (2) years of Patient Accounting experience or comparable experience in a healthcare related setting to be determined by the hiring Director. Knowledge of UB92 and 1500 form; Medicare and/or Medi-Cal guideline; Commercial Insurance, CPT, HCPC, and ICD9/ICD10 coding methodologies.

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence if required.

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages if required.

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Works well under pressure. Multi-tasks.

To perform this job successfully, an individual should have knowledge of office machines and computer data entry. Knowledge of Computer filing systems and Microsoft applications.


LICENSURE/CERTIFICATIONS:
To perform this job successfully, an individual should be a high school graduate.


Responsibilities and Essential Functions:
*Indicates Essential Function

1 * Performs all billing and/or collection functions competently employing the Patient Accounting Business System and electronic claims scrubber installed by the organization for successful resolution of patient accounts receivable.
2 * Monitors and maintains large inventory of patient accounts in an efficient and organized manner. This shall include the entire inventory being worked and documentation of tasks performed entered in the HIS System. Documentation of account activity reflects compliance with established hospital policies and procedures.
3 * Reviews state and federal bulletins and memos to keep informed of any new regulations and/or coding requirements mandated for patient accounting.
4 * Follows all Hospital and department guidelines regarding write-offs, refunds and revisions to individual accounts for corrective purposes.
5 * Documentation of account activity reflects compliance with established hospital policies and procedures.
6 * Meets with collection representatives, patients or any other individuals that have legal rights or obligations on accounts to assist in the prompt resolution of outstanding patient accounts receivable.