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About the Role
This role involves managing the non-medical aspects of patient hospitalization related to payment for care and treatment, maintaining cooperative relationships with patients and families, and facilitating payment for hospital services.
Responsibilities
- Contact self-pay patients during hospitalization to discuss costs, billing, and financial arrangements.
- Arrange for patient payments according to established guidelines.
- Advise patients and families on available financial benefits and resources.
- Collect on delinquent accounts by establishing payment arrangements, monitoring payments, and following up on lapses.
- Submit insurance claims electronically and/or via paper for primary and secondary claims.
- Access internet websites to determine claim eligibility, third-party regulations, and updates.
- Contact third-party payers for unpaid claims, follow up on rejections, and submit corrected claims.
- Verify insurance coverage or benefit eligibility with insurance carriers, employers, and government agencies.
- Work with the Department of Social Services to report spend-down balances and Medicaid application status.
- Perform documentation and follow-up for incorrect or denied payments.
- Receive patient payments, record them on patient accounts, and reconcile accounts.
- Contact referring providers for missing account information.
- Reconcile aged patient and insurance accounts, and follow up on outstanding balances.
- Check final bills for accuracy, bill patients, and maintain electronic records of bills, payments, and payment arrangements.
- Refer delinquent accounts to collection agencies and reconcile related reports and payments.
- Offer and apply charity care assistance to eligible patients and notify other providers of discounts.
- Maintain Personal Incident Accounts (PIA) for nursing home residents.
- Sort and file correspondence, answer phones, write appeal letters for claim denials, photocopy, handle daily mail, and order office supplies.
- Maintain quality results by following standards.
- Maintain work operations by following policies and procedures and reporting compliance issues.
- Report patient care or billing complaints to the compliance officer.
Requirements
- Graduation from high school and one year of clerical experience; or Two years of full-time clerical experience; or An equivalent combination of training and experience.
Skills
- Office terminology, procedures, and equipment
- Business arithmetic and English
- Ability to understand and follow oral and written instructions
- Ability to operate a personal computer and use common office software programs
- Clerical ability
- Ability to establish and maintain cooperative relationships with others
- Accuracy
Education Level
- High school graduation
Salary/Compensations
- $20.29—$26.30 USD