Self Pay Follow Up Specialist

Rogers Behavioral Health•Oconomowoc, WI

About The Position

The Self-Pay Billing and Follow-Up Specialist resolves self-pay accounts while maintaining strong relationships with patients, guarantors, and business office departments. The role uses behavioral health billing knowledge and customer service skills to collect payments and connect patients with financial resources, supporting patient satisfaction and Rogers Behavioral Health’s financial solvency. The specialist communicates with patients and other parties by telephone, email, and mail; explains insurance and organizational financial processes; addresses concerns; negotiates payments and payment plans; and helps patients access available financial assistance. The role also uses reports to reduce accounts receivable, follows up on outstanding accounts, and works toward a three-business-day turnaround time. The position contributes to department and organizational goals, maintains policies and procedures, and participates in staff meetings, committees, performance-improvement activities, and professional development. It includes supporting regulatory compliance, educating colleagues as directed, and providing professional, timely communication with internal and external parties.

Requirements

High school diploma or GED required.
One to two years of experience in a clerical or customer-service role required.
Full understanding of customer service and insurance follow-up processes, including billing, collections, managed care, Medicare, Medicaid, and commercial practices.
Well-developed people skills.
Working knowledge of explanations of benefits (EOB), CPT, HCFA, UB04, authorizations/referrals, and revenue-cycle workflow.
Intermediate computer skills, including use of Microsoft Office Suites.
Valid Wisconsin driver license and insurable status under the Rogers Memorial Hospital insurance policy.
Exceptional verbal and written customer-service and interpersonal communication skills.
Ability to multitask and manage time effectively, work autonomously and as part of a team, and maintain records and assist with billing questions using numerical skills.
Ability to read and communicate through written, verbal, and auditory skills; verbal and hearing ability to interact with patients and employees.
Tact, logical thinking, and discretion to interact effectively and make decisions concerning policies, procedures, and standards.
Ability to perform job duties as verified by a post-employment physical examination by a licensed physician; ability to travel by car and sit for extended periods.

Nice To Haves

Associate degree in Healthcare Administration or a related field.
Experience in healthcare negotiation or collections.

Responsibilities

Handle telephone, email, and written communications to resolve outstanding self-pay balances promptly and respectfully.
Provide customer service that supports patient and guarantor relations and contributes to a positive work environment and financial outcomes.
Listen to customers, explain insurance billing and organizational financial processes and policies, de-escalate calls, and resolve concerns.
Negotiate full payment and establish agreeable payment plans under current policies; offer available financial assistance.
Respond promptly to voicemail and email messages from patients, guarantors, and other parties.
Use available reports to reduce accounts receivable, report errors or issues to leadership, and focus on a three-business-day turnaround time.
Answer questions and solve problems for external users of Rogers services; confirm understanding of solutions and provide additional education as needed.
Collaborate with the team on ideas to resolve problems, improve patient service, and increase productivity.
Make follow-up outbound calls as part of case resolution and comply with HIPAA requirements and established timeframes.
Meet goals relating to accuracy, productivity, accounts-receivable days, cash collections, avoidable write-offs, and reimbursement metrics.
Attend staff meetings, educational seminars, and workshops for ongoing professional development.
Promote department goals and the Rogers mission, communicate goals to colleagues, demonstrate measurable achievement, and maintain department policies and procedures.
Follow requirements and guidelines from external agencies, including the Joint Commission and State of Wisconsin.
Maintain or communicate functional backlog to the appropriate party at the designated time.
Educate inexperienced staff about relevant regulations or requirements as directed, and support and train student interns as directed.
Understand and apply Joint Commission and other regulatory requirements; participate in learning activities and educate other disciplines about department regulations.
Participate as directed in Rogers committees, performance-improvement team meetings, and team projects.
Demonstrate punctuality, preparedness, effective communication, organization, and a positive, solution-focused approach; attend marketing department meetings as needed.
Participate in the performance-improvement program, apply its model to departmental activities, and contribute to or create improvement teams and plans.
Conduct oneself professionally, respond to inquiries and complete tasks in a timely manner, communicate positively, address peer issues constructively, and communicate concerns with proposed solutions.
Attend outside seminars or educational classes to support professional growth and maintain a professional attitude and image when interacting with external parties.
Comply with Rogers policies and procedures, including Human Resources, Infection Control, and Employee Health policies and programs.
Perform other duties as assigned.