BASIC PURPOSE OF THE JOB

Responsible for customer satisfaction and impression of Patient Financial Services with our families in the collection process. Works timely and closely with families to address questions/concerns and ensures proper resolution of problems and concerns.  Gives feedback to team leader on ways to improve daily processes and improve collections. Ensures accuracy of data on other teams and gives feedback on process improvements needed. Ensures exceptional customer service with our families.

REPORTS TO

• Lead Inpatient Account Rep / Lead Outpatient Account Rep

JOB REQUIREMENTS

Supervisory Responsibilities: NO

Minimum Education: High School Diploma/GED

License/Certification Required: None

Minimum Work Experience: Hospital billing and collection experience preferred.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

• Excellent customer service skills and ability to work well with a team required
• Familiar with rules and regulations of CMS and other third party payers to ensure proper collection of insurance data to finalize claims for proper billing to proper payer on first time claim submission
• Ability to work with insurance companies to ensure timely payment of claims
• Problem solving skills required

DUTIES AND RESPONSIBILITIES

• Answers calls in a timely manner and addresses families questions or concerns: If unable to process and finalized issue on call, records appropriate documentation to explain the delay and follow up action Collection problems are reported to team leader/manager to ensure timely correction of issues. Reference policies and procedures to clarify actions or see proper team leader/manager. Stays current with specific insurance company requirements to ensure proper hand off to insurance collectors when needed.
• Ensures at least one touch point on accounts prior to collections and proper discounts were given. Reports if accounts are being held over 120 days prior to placement with agencies
• Works effectively with ancillary departments, families and internal teams to ensure a seamless process flow between departments and the revenue cycle: Notifies staff when applicable of insurance changes to ensure proper authorizations are obtained. Notifies families based on office policies to assist in COB updates, insurance disputes etc. Adds and verifies new insurance when found or obtained by families and queues claims as needed.
• Creates team environment with other departments to problem solve issues
• Documents all accounts properly. All interactions require a note posted. Notes will be of a nature they could be shared as part of a legal document or with the family.
• Attends all required safety training and CBL requirements
• Maintains professional composure and confidence during stressful situations
• Maintain confidentiality of all hospital and patient information at all times as observed by management and peers: Will not discuss any patient information in public areas. Will not discuss any patient with friends, family who may call to ask about a child who has been here. Will only discuss accounts with other staff on a need to know basis to ensure payment of the claim or resolution of a problem. Only shares minimal information needed by others to do the job. Will not view accounts of friends, family member unless requested by the person responsible for the bill. Will hand off to another team member when working an account that could be considered a breach of privacy by a neighbor’s child, family member etc.
• Patient/Family Complaints are handled in a confidential, timely and professional manner: Calls are answered timely and families are given a response within 24 hours as observed by management. Takes initiative on the call to settle any disputes while on the call when possible. Always ends conversation with family after a complaint or dispute with “is there anything else I can do for you today” as observed by management
• Willingly accepts any other assignment that may be requested.
• Continuously displays a “can do” attitude within the department and across department lines to contribute to the overall focus on service excellence at the hospital
• Identifies problems, offers solutions, and communicates with Management as needed: Recognizes problems and works with team leader to come up long term solution to solve the problem. As observed by management. Sees problems as an opportunity to problem solve and improve work for team as observed by management. Talks openly with management to make them aware of process issues and suggest training opportunities, process improvement for the department/team. Contributes ideas on processes that need to i