Senior A/R Specialist

White Plains Hospital • White Plains, NY

129d • $61,972 - $92,959

About The Position

As the Senior Accounts Receivable Specialist, you are responsible for motivating the Patient Accounts team daily to provide guidance, help troubleshoot, resolve issues, and educate on the process. Assists Supervisor and Manager with the daily activities of the department to ensure department standards are regularly met, including policies and procedures being followed, as well as assuring staff are well versed in payer contracts. Acts as subject-matter expert with EMR systems, department procedures, workflows and continually educates Patient Accounts staff on all aspects of their role, such as follow-up, special projects, and accounts receivable.

Requirements

• High School Diploma or GED required.
• Graduate of an accredited college or university with a B.S. in Business/Healthcare Administration strongly preferred or equivalent combination of education and related work experience.
• Minimum of 3 to 5 years of hospital patient accounting / business office experience required.
• Previous Team Lead experience in a hospital setting is strongly preferred.
• Familiarity with electronic medical record systems, EPIC preferred.
• Proficiency with Microsoft office/Excel to include reporting and executive level is required.
• Strong leadership skillset with the ability to educate and motivate team members on Patient Account functions.
• Strong communication skills required.
• Knowledge of medical terminology required.
• Must be detail-oriented, able to problem-solve, multitask and perform various patient accounting duties on demand.
• Effective 12/1/2022, the HBI (Healthcare Business Insights) one-time certification course is required and must be completed during the onboarding period and prior to the start date (Certified Patient Financial Services Specialist - CPFSS).

Responsibilities

• Understands and adds to the WPH Performance Standards, Policies and Behaviors.
• Completes review of third-party outstanding balances and takes appropriate steps to resolve and reconcile outstanding balances striving to meet best practice performance.
• Reviews correspondence for appropriate action to resolve accounts.
• Researches and initiates refunds to patients or insurance carriers as needed.
• Sends inquiries to patients regarding inaccurate or incomplete information.
• Completes charge adjustments and allowances entries on accounts as needed.
• Recodes accounts by insurance carrier and plan number and enters into the hospital EMR for re-billing purposes.
• Processes rejections on third party accounts.
• Reviews online billing edits for errors, corrections, or missing information.
• Assures adherence to federal and state billing regulations.
• Monitors host system and biller scrubber to ensure timely resolution of unbilled accounts.
• Completes rebilling process for late charges daily.
• Reviews third party remittance advice to ensure proper payment is received from insurance carrier based on contract arrangement.
• Works with vendors as necessary to reconcile and resolve outstanding accounts.
• Assures payers pay claims timely and according to contract provisions.
• Responsible for aging review and high-risk accounts review.
• Responsible for training of staff and assisting with staff performance audits following the WPH Revenue Cycle Performance Expectations.
• Responsible for quality reviews for the staff to lead team to meet goals and performance metrics.
• Responsible for reporting to management regarding billing and claim delays.
• Responsible for escalating management issues as identified.
• Responsible to set department and or unit meetings weekly, bi-weekly and or monthly.
• Works in conjunction with management to identify issues and trends and communicate information effectively.
• Contributes to the development and standardizing workflows and procedures.
• Assists management and is a positive change agent in all departmental employee engagement initiatives.
• Works with staff to improve both intradepartmental and employee satisfaction maintained.
• Responds to concerns and/or complaints from patients, the public, medical staff, subordinates, and/or other hospital employees pertaining to assigned areas in order to maintain positive customer relations.
• Assists leadership with the oversight of the preparation and maintenance of documents and information in order to comply with administrative policies as well as JCAHO and other regulations.
• Performs all other related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Hospitals
• Education Level: High school or GED