This position provides Patient Accounting support to meet individual team and department goals. Works collaboratively as a team and shares the responsibility of ensuring accuracy and timeliness in all phases of the Patient Accounting billing and collections processes.
1. *Utilizes knowledge and understanding of healthcare reimbursement rules and regulations of third party payors and general coding practices to bring the account to resolution in a timely manner within the realm of assigned duties.
2. *Identifies refunds, trends, initiate requests and send through established channels using KRH Patient Accounting policy and procedure. Ensures that all accounts are processed and resolved in a timely manner.
3. *Documents all communication regarding accounts in the appropriate computer databases, efficiently. Provides detailed, accurate documentation on patient accounts as instructed.
4. *Utilizes available means to maintain current demographic, insurance and collections information.
5. *Acts as a liaison between patients, clients, providers, third party agencies and KRH departments regarding Patient Accounting questions, payment issues and other related inquiries. This includes responsibility for obtaining Prior Authorizations from insurance companies.
6. *Analyzes and interprets account data to allow for claim and payment resolution and, when appropriate, for adjudication and resolution of claims.
7. *Interprets explanation of benefits message codes in order to identify payment discrepancies and resolves or refers to the appropriate party.
8. *Maintains regular communication with leadership regarding customer interactions and workload.
9. *In the absence of a specific written policy or procedure, will use the Fair Debt Collection Practices Act and other applicable Federal statues as guidelines.
10. *Meets established productivity and quality goals for assigned work, as well as various HIT systems for reference.
11. *Maintains a professional, positive and “team-player” attitude and accepts and acts upon all duties and/or projects assigned by Management to the best of his/her ability.
1. Minimum of one (1) years’ experience in a business office environment, medical office and healthcare background preferred.
2. Certification as an AAHAM Certified Revenue Cycle Specialist – Institutional (CRCS-1) or AAHAM Certified Revenue Cycle Specialist – Professional (CRCS-P) preferred.
3. Proven ability to establish and maintain effective working relationships with patients, organization staff members, and the public.
4. Possess ability to work independently as well as function as part of a team.
5. Possess skills in time-management, organization, prioritization, and ability to communicate via written and verbal communication.
6. Possess and maintain computer skills to include working knowledge of Word, Outlook, Excel and the ability to learn other software as needed is required.
7. Proven ability to maintain confidentiality and understand HIPAA.