What are the responsibilities and job description for the Patient Financial Rep 2 - Single Business Office - Full Time position at Guthrie?
Position Summary:
Concentrates on the Single Billing Office customer service needs of patients and collection of patients’ delinquent accounts through automatic call distribution (ACD), scheduled appointment lists, self‐pay follow up work queues, face‐to‐face contact and mail, email and eGuthrie correspondence.
Addresses billing inquiries and more complex billing issues posed by patients and acts upon patients’ requests associated with assigned patient accounts in a responsive and informative manner, as deemed appropriate. Establishes communication with patients by coordinating with other CBO and clinical departments for patients identified as financial risk with scheduled appointments to discuss with the patient all methods of payment and assist with financial assistance, as applicable, for account resolution. Guides patients to establish a means of meeting their financial obligations in a manner which protects the financial standing of Guthrie Medical Group, Robert Packer Hospital, Corning Hospital, Troy Community Hospital, Towanda Memorial Hospital and Cortland Medical Center.
Education, License & Cert:
Associates degree preferred. High School diploma or equivalent required.
Experience:
Minimum of 2 years applicable, transferable, work experience required.
Background in health care financial services, collections, medical billing, and insurance regulations preferred. Must possess a working knowledge of basic health care billing and coding. Experience with office software and spreadsheets preferred. Aptitude for financial equations, speed in calculation, attention to detail, and ability to multi‐task.
Excellent organizational and customer service skills a must. Requires excellent listening, verbal and written communication and interpersonal skills.
Essential Functions:
1. Provides excellent customer service and alternate methods of payment to resolve self‐pay account balances through patient communication initiated by incoming calls, outbound calls, mail, email, eGuthrie, and Guthrie’s online payment portal at www.Guthrie.org. Respects confidentiality when handling patient accounts and documents any patient contact and the follow up action taken.
2. Informs and explains any outstanding balance to patients and accepts payment via credit card, check or cash and discusses standard payment options according to The Guthrie Clinic policy guidelines.
3. Assesses the patient’s financial ability to pay outstanding balances through account research, discussions with the patient and use of The Guthrie Clinic’s Financial Assistance Program. Works with patients who are considered financial risks before their appointment by flagging upcoming scheduled appointments and establishes communication with other departments to offer and discuss all methods of payment available to meet the patients’ needs and Guthrie’s financial policies. Offers the program application and staff assists in completing the application process when applicable.
4. Provides account follow up and training to staff with more complex patient account questions and coordinates with insurance and reimbursement staff for coding and insurance issues for account resolution on behalf of the patient, and maintains ongoing training of employees as assigned.
5. Updates patient demographic and insurance information and follows through on any filing of insurance, as needed. Reviews third party payment denials as requested by the patient and provides additional information to the insurance company for payment review on behalf of the patient. Rebills patient primary, secondary or tertiary insurance as deemed appropriate.
6. Reviews delinquent accounts and performs limited skip tracing analysis to locate delinquent patients, when appropriate, to determine such data as previously billed, statements sent and collection action taken, the status and extent of any insurance coverage, and any payment plan delinquency in order to contact the patient to confirm the account balance and to ensure the patient understands their financial obligations to The Guthrie Clinic. Refers accounts to external collection agency after account is deemed “uncollectable” according to The Guthrie Clinic policy guidelines and refers patients to collection agency for account review and payment arrangements for their collection balances.
7. Exercising discretion and judgement, uses negotiation techniques to develop flexible, creative options for patients determined to be “good risk”. Understands and explains standard payment procedures and policies established by The Guthrie Clinic.
8. Researches self‐pay credit balances and refund requests and gathers supporting documentation to determine credit resolution and submit refund requests when applicable through the appropriate Accounts Payables system process. Researches appropriateness of administrative and small balance write offs and charge corrections and gathers supporting documentation to submit write‐off recommendations to manager for approval, as appropriate.
9. Provides itemized statements as requested by patients and to other outside representatives as authorized by the patient. Maintains knowledge of and complies with The Guthrie Clinic policies and procedures and FDCPA guidelines and third‐party requirements.
10. Assesses deceased and bankruptcy accounts and takes appropriate measures.
Other Duties:
1. Other duties as assigned.
Concentrates on the Single Billing Office customer service needs of patients and collection of patients’ delinquent accounts through automatic call distribution (ACD), scheduled appointment lists, self‐pay follow up work queues, face‐to‐face contact and mail, email and eGuthrie correspondence.
Addresses billing inquiries and more complex billing issues posed by patients and acts upon patients’ requests associated with assigned patient accounts in a responsive and informative manner, as deemed appropriate. Establishes communication with patients by coordinating with other CBO and clinical departments for patients identified as financial risk with scheduled appointments to discuss with the patient all methods of payment and assist with financial assistance, as applicable, for account resolution. Guides patients to establish a means of meeting their financial obligations in a manner which protects the financial standing of Guthrie Medical Group, Robert Packer Hospital, Corning Hospital, Troy Community Hospital, Towanda Memorial Hospital and Cortland Medical Center.
Education, License & Cert:
Associates degree preferred. High School diploma or equivalent required.
Experience:
Minimum of 2 years applicable, transferable, work experience required.
Background in health care financial services, collections, medical billing, and insurance regulations preferred. Must possess a working knowledge of basic health care billing and coding. Experience with office software and spreadsheets preferred. Aptitude for financial equations, speed in calculation, attention to detail, and ability to multi‐task.
Excellent organizational and customer service skills a must. Requires excellent listening, verbal and written communication and interpersonal skills.
Essential Functions:
1. Provides excellent customer service and alternate methods of payment to resolve self‐pay account balances through patient communication initiated by incoming calls, outbound calls, mail, email, eGuthrie, and Guthrie’s online payment portal at www.Guthrie.org. Respects confidentiality when handling patient accounts and documents any patient contact and the follow up action taken.
2. Informs and explains any outstanding balance to patients and accepts payment via credit card, check or cash and discusses standard payment options according to The Guthrie Clinic policy guidelines.
3. Assesses the patient’s financial ability to pay outstanding balances through account research, discussions with the patient and use of The Guthrie Clinic’s Financial Assistance Program. Works with patients who are considered financial risks before their appointment by flagging upcoming scheduled appointments and establishes communication with other departments to offer and discuss all methods of payment available to meet the patients’ needs and Guthrie’s financial policies. Offers the program application and staff assists in completing the application process when applicable.
4. Provides account follow up and training to staff with more complex patient account questions and coordinates with insurance and reimbursement staff for coding and insurance issues for account resolution on behalf of the patient, and maintains ongoing training of employees as assigned.
5. Updates patient demographic and insurance information and follows through on any filing of insurance, as needed. Reviews third party payment denials as requested by the patient and provides additional information to the insurance company for payment review on behalf of the patient. Rebills patient primary, secondary or tertiary insurance as deemed appropriate.
6. Reviews delinquent accounts and performs limited skip tracing analysis to locate delinquent patients, when appropriate, to determine such data as previously billed, statements sent and collection action taken, the status and extent of any insurance coverage, and any payment plan delinquency in order to contact the patient to confirm the account balance and to ensure the patient understands their financial obligations to The Guthrie Clinic. Refers accounts to external collection agency after account is deemed “uncollectable” according to The Guthrie Clinic policy guidelines and refers patients to collection agency for account review and payment arrangements for their collection balances.
7. Exercising discretion and judgement, uses negotiation techniques to develop flexible, creative options for patients determined to be “good risk”. Understands and explains standard payment procedures and policies established by The Guthrie Clinic.
8. Researches self‐pay credit balances and refund requests and gathers supporting documentation to determine credit resolution and submit refund requests when applicable through the appropriate Accounts Payables system process. Researches appropriateness of administrative and small balance write offs and charge corrections and gathers supporting documentation to submit write‐off recommendations to manager for approval, as appropriate.
9. Provides itemized statements as requested by patients and to other outside representatives as authorized by the patient. Maintains knowledge of and complies with The Guthrie Clinic policies and procedures and FDCPA guidelines and third‐party requirements.
10. Assesses deceased and bankruptcy accounts and takes appropriate measures.
Other Duties:
1. Other duties as assigned.