PATIENT ACCT REP, Customer Service Self Pay/Bad Debt

Oneida Health•Oneida, NY

13d•$18 - $23•Onsite

About The Position

Oneida Health is currently seeking an experienced and detail-oriented full-time Patient Account / Customer Service Rep to work at our corporate office in Canastota. As a Patient Account/ Customer Service Rep, your main responsibilities will be to The Patient Account Representative – Self Pay and Bad Debt, coordinates, monitors, reports and facilitates the accurate reporting and maintenance of the outsourced accounts in a self-pay classification and bad debt accounts transferred to outside collection agents. Balances to inventories and prepares monthly activity reporting.

Requirements

High School diploma or GED
Two + years’ experience directly related to health care claims processing.
Familiarity with healthcare medical terminology and coding.
Basic knowledge in the reimbursement guidelines for all major third party and governmental payers; Medicaid, Medicare, HMO’s; Commercial, Worker’s Compensation and Third Party Liability.
Good communication and interpersonal skills.
Basic knowledge of PC and Microsoft Office Suite use and application and use of internet.
Knowledge of patient accounting systems.
Understands and complies with HIPAA and Protected Health Information rules and regulations.

Responsibilities

Posts manual cash deposits on a daily basis as assigned.
Receives and posts and reconciles assigned payment batches to the appropriate patient account from the remittance advice or checks using the appropriate payment/adjustment code to insurance.
Reviews daily automated posting as assigned by payer and assures the payment batches are reconciled to the account postings.
Reviews cash posting error reporting and completes any appropriate corrections such as financial class changes, updating payer information, and/or changing the priority of the payer to accounts to ensure payments are posted accurately.
Insures contractual and other approved adjustments are posted timely and accounts are reconciled and the account balances are correctly reflected in the appropriate payer responsibility in the Patient Accounting System.
Researches and codes each payment receipt accurately, thoroughly and timely according to the Payment Posting procedures.
Documents payment information on accounts in the Patient Accounting host system.
Batches cash receipts, balances them to the deposit, and maintains the batch control log of payments daily.
Sorts the mail received in the deposit and forwards any non-payment posting mail appropriate.
Insures zero (0) payment and/or informational “nonpayment requests” are timely and accurately forwarded/assigned to the account follow up team for additional follow up and/or denial resolution.
Documents all actions taken on accounts in the system account notes to ensure all prior actions are noted and understandable by others.
Performs routine audits of assigned individual accounts to resolve all discrepancies in account balances – credit balances, underpayments, inaccurate contractual allowances and performs necessary actions to resolve the account balance.
Informs the supervisor of any problems or changes in payer requirements and exercises independent judgment to analyze and report repetitive denials so that corrective actions can be taken.
Reconciles imports and return account activity with the vendors.
Reviews differences and works with vendors to resolve.
Reviews and audits billings from outsourced activities and recommends for payment or payment with changes.
Reconciles recoveries of Bad Debt on a monthly basis.
Works self-pay credit balances and resolves.
Prepares Medicare Bad Debt schedule and maintains on a monthly basis.
Gathers and stores collection efforts backup and proof to insure bad debt reimbursement.
Acts as hospital liaison for all outsourced account activity – enters and updates account information as received and routes for appropriate action – rebill, adjustment, financial assistance, closure, etc.
Produces monthly reporting of outsourced activities performance.
Compares to prior periods and established benchmarks.
Monitors assigned work lists at all sources and insures expeditious resolution.
Works with other departmental representatives in resolve.
Reports unresolved issues and concerns impeding the collection process and to ensure successful account resolution.
Complies with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information.
Seeks advice and guidance as necessary to ensure proper understanding.
Performs other duties as assigned by the Supervisor.
Handles telephone information with courtesy, accuracy, and respect for confidentiality; receives information and distributes messages appropriately.
Consistently communicates appropriately with patients and staff and responds to requests for assistance promptly.
Provides accurate communication in verbal, nonverbal and written form.
Listens effectively.
Communicates effectively with supervisor, including but not limited to changes of operation.
Reports to supervisor regularly on the status of ongoing projects.
Assists with orientation of new staff.
Follows proper chain of command appropriately to resolve problems and concerns.
Treats patients and their families with respect and dignity, and ensures confidentiality of patient records.
Provides positive and productive support to the team and promotes teamwork.
Is kind, courteous, respectful and professional in all interactions with all hospital personnel at all levels.
Serves as coverage for incoming calls both from internal sources as well as external sources and routes appropriately.
Determines nature of call and routes to the appropriate person or ascertains a clear and concise accounting of the nature of the call and documents same in patient file notes.
Reviews account with patient and if problem resolution is evident, responds accurately and appropriately or research account.
This could include but not limited to researching insurance billing information, reviewing postings for mathematical accuracy, pulling and reviewing explanations of benefits, reviewing contractual terms to determine if applied accurately.
Determines nature of problem.
Reviews with appropriate personnel and forwards for proper approvals if resolve is not within the authority of the representative.
Enters into Patient Accounting System new information provided by the patient and/or guarantor
Provides application for charity care/financial assistance when appropriate.
Authors and routes correspondence
Requests rebills as necessary
Pull explanation of benefits as needed to respond to customer inquiry
Complies with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information.
Seeks advice and guidance as necessary to ensure proper understanding.
Provides General office support – opens and distributes mail per established policy and procedures.