Patient Financial Service Representative II - TMCOne - Billing Services
Processes monies/payments/adjustments related to patient accounts and ensures proper verification, reconciliation, and reporting of transactions.
Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.
Collects partial payments prior to admission in accordance with hospital policy.
Reviews admissions records to ensure accurate financial and biographical data and documentation have been obtained and properly entered into hospital records.
Provides information regarding patient accounts in response to inquiries, safeguarding confidential information in verbal replies and correspondence.
Records, reviews, and applies monies/payments/adjustments received for patient accounts and provides information/forms to appropriate departments.
Analyzes patient accounts, determines non-collectable accounts, and recommends bad debt or charity write-offs when applicable; analyzes and processes contractual write-offs.
Arranges payment methods or extensions of credit with patients or representatives; evaluates accounts and determines payment dates based on patient’s ability to pay and hospital policies; explains charges, services, and hospital policy regarding payment of bills.
Arranges account collections and contacts carriers to follow-up on balances due.
Maintains current working knowledge of payer regulations, contractual agreements, computer updates, and new collection tools including understanding of the Fair Debt Collection Practice Act.
Provides information about external financial assistance, including recommending third parties.
Processes Accounts Payable transactions such as: checks and posts payments to accounts receivable and verifies account balances; prepares, reconciles, balances, and batches daily deposits and prepares receipts for deposits; verifies totals on reports and forms as required. Reviews accounts with unusual balances after posting payments and adjustments. Researches and transfers monies between logs, as needed.
Reviews and processes accounts for timely refund.
Maintains and completes unidentified payments.
Processes daily Medicare denial reports.
Initiates related computer-generated reports.
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), completion of vocational medical office training desired, or an equivalent combination of relevant education and experience.
EXPERIENCE: Two (2) years of related experience such as cash handling, data entry, administrative assistant, customer service, financial billing or scheduling experience for diagnostic testing and/or surgery. Experience in a medical office or hospital setting preferred.
LICENSURE OR CERTIFICATION: None required.
KNOWLEDGE, SKILLS AND ABILITIES:
Knowledge of medical insurance practices and policies and regulations.
Knowledge of third party payers and AHCCCS guidelines.
Knowledge of medical terminology and coding.
Skill in evaluating bills and paying or requesting collection in a timely manner.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals,
Ability to complete routine reports and correspondence.
Ability to listen and accurately interpret others’ communication or instructions to take appropriate action.
Ability to speak effectively before groups of customers or employees of organization.
Ability to calculate figures and compute rate, ratio, and percent and to draw and interpret bar graphs and ability to apply basic algebraic concepts.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to deal with problems involving several concrete variables in standardized situations.