Essential Functions/Responsibilities:

Essential functions are the duties and responsibilities that are essential to the position (not a task list). Do not include if less than 5% of work time is spent on this duty. Be specific without giving explicit instructions on how to perform the task. Do not include duties that are to be performed in the future. Duties should be action oriented and avoid vague or general statements.

% of Time

(annually)

Customer Service

· Receives patients, visitors and answers telephone calls

· Creates a welcoming environment for all. Effectively managing positive relationships with other team members and other departments.

· Schedules walk in patient appointments

15%

Billing/Insurance/Collections/Denials

· Verifies insurance eligibility and insurance coverage for patients via phone or internet.

· Counsel patients on coverage, cost estimates, patient financial responsibility, and financial assistance applications.

· Gather, verify and enter demographic and billing information for new and established patients to complete the electronic health record and insurance claim for each patient visit.

· Responds to patient questions regarding their account and ensures solutions to patient billing, complaints or concerns.

· Demonstrates ability to effectively manage details by accurately completing patient registration and maintaining medical records in all areas of the hospital.

· Collects point of service payments, issues receipts and reconciles daily receivable activity to prepare for the daily deposits.

· Monitors and completes account on multiple work queues in EPIC for billing accuracy for providers and patients.

· Problem solves, analyzes and collaborates with patient, Insurance Companies, Hospital Departments, Revenue Integrity, and Central Billing Office to resolve billing and denial issues, including correcting claim or account errors.

· Documents denials and billing issues to identify process improvements in order to maximize efficiency and ensure proper payment for the hospital.

· Performs other duties as assigned.

75%

Basic UPH Performance Criteria

· Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.

· Demonstrates ability to meet business needs of department with regular, reliable attendance.

· Employee maintains current licenses and/or certifications required for the position.

· Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.

· Completes all annual education and competency requirements within the calendar year.

· Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.

10%

Disclaimer: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Demonstration of UPH Values and Standards of Behaviors

Consistently demonstrates UnityPoint Health’s values in the performance of job duties and responsibilities

Foster Unity:

· Leverage the skills and abilities of each person to enable great teams.

· Collaborate across departments, facilities, business units and regions.

· Seek to understand and are open to diverse thoughts and perspectives.

Own The Moment:

· Connect with each person treating them with courtesy, compassion, empathy and respect

· Enthusiastically engage in our work.

· Accountable for our individual actions and our team performance.

· Responsible for solving problems regardless of the origin.

Champion Excellence:

· Commit to the best outcomes and highest quality.

· Have a relentless focus on exceeding expectations.

· Believe in sharing our results, learning from our mistakes and celebrating our successes.

Seize Opportunities:

· Embrace and promote innovation and transformation.

· Create partnerships that improve care delivery in our communities.

· Have the courage to challenge the status quo.

Minimum Requirements

Identify items that are minimally required to perform the essential functions of this position.

Preferred or Specialized

Not required to perform the essential functions of the position.

Education:

High School Diploma

Associate’s Degree

Experience:

· Prior experience in a medical office

· Prior insurance knowledge

License(s)/Certification(s):

Valid driver’s license when driving any vehicle for work-related reasons.

· Experience with Medical Insurance processing

· Medical Terminology

Knowledge/Skills/Abilities:

· Writes, reads, comprehends and speaks fluent English.

· Multicultural sensitivity

· Microsoft Office – Basic computer skills

· Customer/Patient focused

· Critical thinking skills using independent judgment in making decisions

· High organizational skills

· Ability to multi-task

· High attention to detail

· Ability to interact effectively with physicians, health care team members, patients and members of their support systems.

Other:

Use of usual and customary equipment used to perform essential functions of the position.