This position is primarily responsible for payment arrangements made for all inpatient and outpatient cases scheduled to enter the facility/clinic. This position works closely with the Case Management Team, Lead Registration Specialist and the Business Office. Responsible for delivering and explaining the Medicare Important Message to patients with Medicare coverage. May research all accounts for previously unidentified insurance and review all accounts that have a patient balance and are over 45 days outstanding. Works collaboratively with other departments to ensure the appropriate paperwork is signed and filed. This person requires excellent customer service skills and the ability to work with minimal supervision.
Patient Accounts Duties:
- Greets patients, families and visitors in a friendly, courteous manner.
- Determines patient responsibility and performs appropriate Point of Service collection.
- Pre-screens patients for Medicaid eligibility and refers them, as appropriate, to the onsite Medicaid Advocate Services for Healthcare (MASH) representative for additional Medicaid eligibility review and application.
- Screens patients for the hospital/clinics financial assistance (i.e., charity) program by determining whether federal poverty guidelines are met; notifies appropriate Business Office personnel of approved coverage so the hospital/clinic bills accordingly.
- Monitors in-house patients for continued stay authorizations. Works with Case Management on continued authorization issues.
- Notifies Business Office management of any non-covered accounts or accounts where the patient responsibility is excessive.
- Communicates with Business Office management on any issues of concern.
- Monitors patient accounts for any collections that are required.
- Serves as liaison with clinical departments, patient and families regarding admission and registration processes.
- Provides detailed explanation of the Important Message from Medicare to Medicare beneficiaries and obtains signatures of same.
- Ensures the Important Message is placed on the patient chart and explained to the patient within 48 hours of admission and again two days prior to the discharge date.
- Assists in developing recommendations to maintain efficient and effective scheduling, precertification, and benefits verification processes.
- Performs other duties as directed to provide the most efficient service to the hospital/clinic in a manner which supports the overall effectiveness for the department and the hospital/clinic.
- Identifies all delinquent accounts according to the collection guidelines.
- Obtains appropriate information necessary to review delinquent accounts.
- Identifies source of payment for delinquent accounts.
- Contacts delinquent accounts and performs collection actions as required by practice guidelines.
- Investigates third-party sources of payment.
- Evaluates patient financial status and establishes budget payment plans for appropriate patients.
- Sends pre-collection notices.
- Reviews accounts for assignment to an external collection agency.
- Answers patient questions concerning bills.
- With the agreement of Business Office management, makes adjustments to patients accounts according to guidelines of practice.
- Processes daily credit card payment report.
- Responsible for proper collection techniques and confidentiality of patient information.
- Other duties as assigned.
- Education: High school degree or equivalent.
- Licensure/Certification: None required.
- Experience: Minimum two years financial experience required. Hospital and/or medical office experience preferred.