Concord Hospital - Laconia, NH

posted about 2 months ago

Laconia, NH
Hospitals

About the position

Working under the supervision of the Customer Service Manager, the Patient Account Resolution Specialist is the hospital's primary resource for all aspects of revenue management, with a focus on self-pay billing. Answering phone calls is a component of this job; however, a majority of our calls are handled by outside vendors. The individual in this role is responsible for Identifying, researching, and resolving sensitive and complicated customer questions and issues that have been escalated by our internal and external stakeholders. These include, but are not limited to: bankruptcy encounters, Patient Relations/Risk questions, questions from CHMG practices and hospital departments, escalated calls and internal reviews from our vendors, insurance management, legal and bad debt requests and follow up, recall reports, recon reports, settlement requests, special programs, and uncollectable encounters. Producing Good Faith Estimates as part of the No Surprises Act and cost of care estimates as part of Price Transparency are important responsibilities of this role. In addition, the individual in this role will be responsible for auditing the quality of our vendor's work as well as reporting and acting on the audit results. The Patient Account Resolution Specialist demonstrates proficiency with complex regulatory and managed care mandates, third party contract requirements, multiple software and electronic systems and/or processes as well as detailed departmental policies and procedures in order to effectively carry out the revenue management functions of the organization.

Responsibilities

  • Identifies, researches, and resolves sensitive and complicated customer questions and issues that have been escalated by our internal and external stakeholders.
  • Ensures our pre-collection, collection, and legal vendors provide high quality customer service.
  • Works all Cerner queue assignments, including, but not limited to: Coding Updates, Customer Service follow up, Customer Service Review, Insurance Modification, Prepaid, and Self Pay Late Charge.
  • Ensures daily Customer Service phone coverage.
  • Commits to continual learning and professional development.
  • Performs other duties as assigned.

Requirements

  • Two years of formal training or education beyond the high school level or two years of related experience and/or training; or equivalent combination of education and experience.
  • Minimum of five years' experience in healthcare revenue operations, preferably in the hospital or medical office setting.
  • Proven mastery of all aspects of the revenue cycle, including: scheduling, registration, financial counseling, charge capture, claim submission, insurance management, claim follow up, transaction posting, reimbursement, customer service, collections, and bad debt management.
  • Familiarity with medical terminology, medical records, and knowledge of healthcare coding systems, including ICD-10, CPT, and HCPCS.
  • Excellent communication, telephone, and computer skills.
  • Ability to manage multiple priorities and deadlines.
  • Basic knowledge of state, federal, and third-party billing/registration regulations and requirements.

Nice-to-haves

  • Bachelor's degree preferred.
  • CRCR certification preferred.

Benefits

  • Equal Employment Opportunity employer.
  • Reasonable accommodations for individuals with disabilities.
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