Patient Account Specialist
Performs self-pay collections or third party billing/collections which includes a complex review of billing and collection activities. Resolves problems and demonstrates complete understanding of payer and/or patient requirements to ensure timely and accurate payment. Makes independent decisions based on the needs of the patients and/or payer situations.
Assists management in maintaining or reducing account receivable (AR) days to meet industry standards and improve organizational cash flows.
Ensures UB04 and HCFA 1500 claims and/or self-pay patient accounts are billed in a timely, complete, and accurate manner in accordance with appropriate guidelines.
Provides information regarding patient accounts in response to inquiries, safeguarding confidential information in verbal replies and correspondence.
Demonstrates understanding of the entire revenue cycle.
Provides routine daily internal and external interface with unit/department management and staff, other service areas, information systems, physicians, physicians’ office staff, patients, software/hardware vendors, and third party payers in order to resolve patient concerns, disputes, and billing audits in order to receive payment.
Assists with problem solving, inquiries, and customer interaction to ensure positive results.
Researches and analyzes any correspondence received related to assigned accounts.
Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.
Analyzes patient accounts, determines non-collectable accounts and recommends bad debt or charity write-offs when applicable; analyzes and processes contractual write offs.
Adheres to TMCH organizational and department-specific safety and confidentiality policies and standards.
Performs related duties as assigned.
EDUCATION: High School diploma or General Education Degree (GED); or an equivalent combination of relevant education and experience.
EXPERIENCE: Varies based on position, see above.
LICENSURE OR CERTIFICATION: None required.