The Self-Pay Collections Specialist III is responsible for follow-up work on high dollar Self Pay account balances. Responsibilities will include supporting unit supervisor and manager in assigned duties, assisting staff with complex cases, in collections of outstanding patient balances, establishing payment arrangements, updating patient and guarantor account with new demographic and insurance coverage information. Representative must exhibit professional and courteous behavior at all times during communications.
Expeditiously handles a large volume of outbound calls on high dollar accounts and perform work in a timely manner.
Attempts to collect full payment from patient or guarantor in a professional and courteous manner.
Establishes payment arrangements per guidelines. Documents terms in billing system.
Applies payments collected over the phone to each date of service.
Handles customer inquiries, disputes and complaints in a professional and courteous manner. Escalates contentious complaints to supervisor or higher management.
Obtains all insurance, demographic, guarantor information and update patient profile as well as bill third party payers as appropriate.
Assists supervisor/manager with monitoring inbound phone calls, call queue wait times and other assigned functions. Assists with training support of new hires.
Assists Specialists I and II with complex cases. Escalates issues and engages supervisor when appropriate.
Meets productivity and quality targets.
High school graduate or GED certificate is required.
A minimum of 3 years’ experience in a physician billing or third party payer environment.
Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
Candidate must demonstrate a strong customer service and patient focused orientation and the ability to communicate, adapt, and respond to complex situations. Including the ability to diffuse complex situations in a calm and professional manner.
Must demonstrate effective communication skills both verbally and written.
Ability to multi-task, prioritize, and manage time effectively.
Functional proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.)
Ability to work independently.
The ideal candidate is a motivated individual with a positive attitude and exceptional work ethic.
Must successfully complete systems training requirements.