The Self-Pay & Financial Counseling & Charge Edits Specialist II is responsible for managing self-pay balances including installment accounts, receiving payments, and processing collection accounts.
Responsible for managing and reviewing self-pay accounts. Receive payments and post amount to customer's account.
Establishes payment arrangements per guidelines. Document terms in billing system.
Handle customer inquiries, disputes and complaints in a professional and courteous manner. Escalate contentious complaints to supervisor or higher management.
Attempt to collect full payment from patient or guarantor in a courteous manner.
Analyze charge review rules that require review.
Execute edits within charge review to achieve account resolution
Obtain all insurance, demographic, guarantor information and update patient profile as well as bill third party payers as appropriate.
Develop solutions to help address patient financial needs in accordance with policies and procedures. Determine financial clearance for a patient's visit or referral.
Work on complex cases that spread across multiple departments. Act as a liaison between departments.
High school graduate or GED certificate is required.
A minimum of 1 year 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.
Patient financial and practice management system experience in Epic and or other of electronic billing systems is preferred.
Knowledge of medical terminology is preferred.
Previous experience in an academic healthcare setting is preferred.