Collection Financial Analyst, CBO

Jackson Health•Miami, FL

11d•Onsite

About The Position

The CBO Collection Financial Analyst performs various interviewing, fact collection, and financial evaluation tasks in connection with credit and collection in a large and diversified hospital serving both non-indigent and indigent patients qualifying for various types of specialized assistance programs. Incumbents may specialize in either credit or collection work or a combination of both. Primary emphasis is on financial counseling with patients from pre-admission through account becoming a discharged zero balance. Incumbents are responsible for interviewing patients, families, or guarantors to explain charges, hospital policy, and payment procedures. The incumbents are also responsible for confirming all commercial insurance and conducting extensive third-party and welfare program findings in order to obtain payments as promptly as possible or direct accounts to a collection agency.

Requirements

Generally requires 3 to 5 years of related experience.
High school diploma is required.
Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
Ability to communicate effectively in both oral and written form.
Ability to handle difficult and stressful situations with critical thinking and professional composure.
Ability to understand and follow instructions.
Knowledge and skill in use of job-appropriate technology and software applications.
Valid license or certification is required as needed, based on the job or specialty.

Nice To Haves

Bachelor's degree in related field is strongly preferred.

Responsibilities

Identify and resolve accounts and patient concerns through the use of JHS Patient Accounting Systems.
Adjudicate patient accounts as appropriate based on dollar threshold and obtain the appropriate approval.
Analyze patient account balances and submit adjustment or payment transfers to the appropriate management approval.
Update JHS Patient Accounting Systems with any changes that may be necessary to accurately reflect the patients demographic and financial information to include but not limited to the patients financial class, insurance eligibility, patient balance, etc. based on follow-up calls or new information through collection efforts or correspondence.
Determine if payments are accurate based on the Payer agreement.
Understand a variety of payment mechanisms from DRGs, Stop Gap, Percent of Charge, Per Diem and/or any other special agreements that JHS has or will contract with to secure payment of the patient receivable.
Contact Payers and Debtors to ensure timely payment and account resolution.
Research, resolve delinquent accounts and document all follow-up activity and post comments into the JHS Patient Accounting System.
Document account activity concisely and in a manner easily understood by anyone who may need access to the patient accounting record, including other staff members within the department, hospital staff members who may need to understand past billing and collection activity, and auditors or others who require billing and collection information and are designated as an approved source (i.e., courts, lawyers, payers, etc.).
Validate and determine if all data on account is accurate to conduct appropriate follow-up activity.
Use daily work lists or other appropriate account listings (ATB, etc.) to determine accounts that need to be worked each day.
Ensure that their assigned management team member is made aware of any issues with accessing their assigned work list or other issues that can impact the volume of work each day.
Routinely work with supervision and management to improve processes, increase accuracy, create efficiencies, and achieve the overall goals of the department.
Identify trends of denials or other payer issues and report those issues to the management team in the CBO.
Quickly respond to changes in Payer requirements and regulations to improve collections and effectively communicate those changes to other members of their team.
Maintain productivity and quality standards in accordance with department policy and procedure.
Continually improve knowledge of Medicare, Medicaid, and other third-party Payers to ensure a clear understanding of Payer requirements that may be required to facilitate the billing and reimbursement process using multiple hospital and Payer systems.
Work with high volume output utilizing telephone, fax, Payer websites, CMS common working file, and/or Medicaid's website.
Work directly with other departments and physicians that may provide information on collecting JHS account receivable.
Develop and maintain good working relationships with others that impact the collection of JHS receivables.
Ensure proper use of all information systems available within the Hospital technology platform.
Comply with HIPPA and JHS requirements as it relates to Patient Health Information.
Use JHS technology systems strictly for their intended use.
Adhere to JHS and Departmental policies and complete annual testing as may be required by various regulatory agencies, JHS, and/or the CBO.
Attend mandatory training and maintain proficiency with the ability to pass job-related skills tests with 85%.
Demonstrate behaviors of service excellence and CARE values (Compassion, Accountability, Respect, and Expertise).
Perform other job duties that may be required to provide the quality and level of service expected by JHS and Revenue Cycle management.