PRIVATE PAY/CLIENT ACCOUNT ANALYST

Min

USD $17.14/Hr.

Max

USD $26.56/Hr.

Overview

Responsible for the collection and follow-up of all outstanding self-pay balances of Patient Accounts in accordance with policies and procedures.  Determines customers’ eligibility for financial assistance programs.  Embodies the Memorial Health System Performance Excellence Standards of Safety, Quality,

Integrity and Stewardship that support our mission, vision and values.

Qualifications

Education:

·     High School or GED equivalent required.

Licensure/Certification/Registry:

·       N/A

Experience:

·     One or more years of health care insurance and/or health care billing experience is required, preferably in the areas of billing, collections, or accounts receivable. Previous experience as a collector is highly desirable.

Other Knowledge/Skills/Abilities:

·       Experience with Microsoft Office products such as Word and Excel preferred.

·       Basic working knowledge of personal computers required and their associate user software is preferred, with the ability to enter, retrieve, and electronically notate system screens.

·       Familiarity with medical terminology, medical procedural (CPT) and diagnosis (ICD-9 & 10) coding and hospital billing claims form UB-04 highly preferred.

·       Ability to multi-task while working on multiple responsibilities simultaneously.

·       Ability to work successful with internal customers and external customers.

·       Highly-developed critical thinking and problem solving-ability to work through complex situations.

·       Knowledge of poverty guidelines, internal/external financial assistance programs and options, medical billing and insurance principles/practices.

·       Demonstrates excellent oral and written communication, customer relations, and listening skills. Must demonstrate the ability to persuade and negotiate effectively.

Responsibilities

Embodies the Memorial Health System Performance Excellence Standards of Safety, Quality, Integrity and Stewardship that support our mission, vision and values:

 

• SAFETY: Prevent Harm - I will put safety first in everything I do.  I will speak up, without fear, on matters of patient and colleague safety.  I will take action to create an environment of zero harm.

 

• QUALITY: Improve Outcomes -  I will continually advance my knowledge and skills.  I will seek out continuous improvement opportunities.  I will deliver evidence-based care that leads to excellence in outcomes.

 

• INTEGRITY: Show respect and Compassion  - I will respect others and show compassion.  I will behave honesty and ethically.  I will be accountable for my attitude, actions and health.

 

• STEWARDSHIP: Reduce Waste - I will use resources wisely and maintain financial stability.  I will work together to coordinate care and services across the health system.  I will promote healthier communities.

 

Analyzes each private pay account proposed for collection referral. Reviews account notes for appropriateness of turnover. Additionally, reviews for Medicaid eligibility along with the potential for financial assistance qualification. Prepares past due accounts for collection. Ensures appropriate collection codes are used for such accounts. Maintains appropriate information needed for Medicare Bad Debt.

 

Assists patients with Financial Assistance applications and bank loans in a timely manner.

 

Ensures proper account notation, resolution, charge posting, and Accounts Payable disbursements to lending institution(s), for defaulted guaranteed (patient) bank loans.

 

Researches all sources of potential financial assistance based on the specifics of each application. This may include Medicare, Medicaid, Financial Assistance, bank loans, COBRA, etc.

 

Once determination is made regarding approval/denial of financial assistance, reviews all accounts both current and in bad debt. Ensures appropriate account adjustments are made and are accurate.

 

Responds to all private pay mail inquiries or requests in a timely manner.

 

Acts as liaison with outsourced call center. Receives and resolves customer complaints, entering quality of care and PHI concerns into Sensor as appropriate. Through account detail review and correspondence from patients, leadership, and colleagues, provides necessary feedback regarding call quality and accuracy of information.

 

Greets customers via telephone and determines nature of inquiry. Assists customers as necessary or refers