Financial Services Specialist

RURAL HEALTH CARE INC dba Aza Health•Palatka, FL

11h

About The Position

The Financial Services Specialist is a full-time position responsible for a wide array of financial and administrative tasks related to patient accounts, billing, and collections. This role involves processing and posting payments, maintaining the accounts receivable database, and reconciling cash receipts. The specialist will investigate and resolve billing problems, make adjustments to patient accounts, and perform collection actions, including contacting patients and resubmitting claims to third parties. Other duties include reviewing accounts for potential assignment to collection agencies, processing patient and insurance refunds, and ensuring accurate and timely reporting. The position requires strong data entry, customer service, and communication skills, along with a basic understanding of CPT/ICD-9 coding and managed care claim processing. The specialist will also assist with coding and error resolution, handle patient inquiries, and maintain confidentiality.

Requirements

Strong knowledge of CPT coding and ICD-9 coding
Understanding of what should be marked on an encounter form
Ability to read and interpret and encounter form
Strong data entry skills
Ability to communicate with other staff members for necessary data and questions
Excellent customer service skills for dealing with patients and co-workers
Ability to work closely with lead cashier
Basic understanding of billing and managed care claim processing
Ability to interpret explanation of benefits from insurance payers

Responsibilities

Process and post checks
Maintain accounts receivable database, including updating account information
Enters data and reconciles the cash receipt log with payment posting totals
Makes adjustments and corrections to patients accounts
Investigate billing problems and formulates solutions, verifies and maintains adjustment/correction records
Participate in educational activities
Maintains strictest confidentiality
Identifies delinquent accounts, aging period and payment source
Reviews each account via computer, reports and other information sources
Performs collections actions including contacting patients by telephone and resubmitting claims to third party
Reviews accounts for possible assignment to collection agency, makes recommendations to Financial Department Supervisor and prepares information for collection agency
Daily review tape and end of day reports
Daily posts, corrects and applies patient and/or insurance payments, processes correspondence front third party payers
Lists unidentified payments to correct accounts, documenting transactions to maintain adequate audit trail
Resolves misdirected payments and returns incorrect payments to sender
Copies any zero payments (denial) to appropriate financial service department specialist for follow-up
Corrects and posts debit/credit adjustments of misapplied payments to ensure accurate and timely reporting on accounts
Answers patients inquiries regarding account balances
Prepares and processes credits and patient and insurance refunds
Responsible for day end reconciliation
Accountable for daily balance
Researches all information needed to complete billing process
Records billing information for verification of claims processing
Works with other staff to follow-up of accounts to work aged accounts
Assists with coding and error resolution
Assists with answering the telephone and provides information as requested without violation of HIPAA security rules
Uses collection management reports to keep accounts receivable current
Uses telephone, mail and other techniques to aid in collection of accounts receivable
Runs routine insurance claim forms and statements
Refers difficult collection problems to supervisor for further action
Answers inquiries and correspondence from patients
Identifies and resolves patient billing complaints
Responsible for processing and filing primary and secondary claims
Maintain office notes in data system for inquiries to patient account including inquires from third party payers
Obtains patient data to key charge information from hospital superbill that is completed by providers
Tracks admissions and discharges to hospital
Follow-up on missing encounters
Compiles and distribute encounter visits weekly
Verify accuracy of billing data and revise any errors
Operate typing, adding, calculating and billing machines
Prepares itemized statements, bills or invoices
Records billing information for verification of claims processing
Reviews documents such as charge slips or hospital records in order to key in charges
Keeps records of invoices and support documents
Maintains spreadsheet for tracking billing information
Assists Customer Care Specialists with inquiries on errors and/or processes
Assists with updates in current data base
Process NSF checks and tracking
Ability to work with internet payer sites