Responsible for the collection and follow-up of all outstanding self-pay balances of LMH and TMH Patient Accounts in accordance with policies and procedures. Determines customers’ eligibility for financial assistance programs
High School or GED equivalent required
One or more years of health care insurance and/or health care billing experience is required, preferably in the areas of billing, collections, or accounts receivable. Previous experience as a collector is highly desirable
Demonstrates excellent oral and written communication, customer relations, and listening skills. Must demonstrate the ability to persuade and negotiate effectively
Analyzes each private pay account proposed for collection referral. Reviews account notes for appropriateness of turnover. Additionally, reviews for Medicaid eligibility along with the potential for financial assistance qualification. Prepares past due accounts for collection. Ensures appropriate collection codes are used for such accounts. Maintains appropriate information needed for Medicare Bad Debt.
Assists patients with Financial Assistance applications and bank loans in a timely manner.
Ensures proper account notation, resolution, charge posting, and Accounts Payable disbursements to lending institution(s), for defaulted guaranteed (patient) bank loans.
Researches all sources of potential financial assistance based on the specifics of each application. This may include Medicare, Medicaid, Financial Assistance, bank loans, COBRA, etc.
Once determination is made regarding approval/denial of financial assistance, reviews all accounts both current and in bad debt. Ensures appropriate account adjustments are made and are accurate.
Responds to all private pay mail inquiries or requests in a timely manner.
Acts as liaison with outsourced call center. Receives and resolves customer complaints, entering quality of care and PHI concerns into Sensor as appropriate. Through account detail review and correspondence from patients, leadership, and colleagues, provides necessary feedback regarding call quality and accuracy of information.
Greets customers via telephone and determines nature of inquiry. Assists customers as necessary or refers them to internal or external sources.
Sets up and reviews payment plan accounts according to policy and procedure.
Runs reports and analyzes data weekly to determine private-pay accounts. Process includes review for potential discounts and/or financial assistance. Works with patient regarding payment options.
Handles incoming correspondence and phone calls related to bad debt accounts referred to collection agencies and respond within departmental performance standards.
Reviews and approves suit authorizations.
Identifies, prioritizes, investigates, and resolves bad debt credit balances, and ensures proper refunds are processed.
Identifies, prioritizes and resolves accounts from various Collection Agency Reports to ensure all accounts are properly adjusted in conjunction with the agency’s monthly cancelled, deceased, and bankruptcy reports.
Receives bankruptcy notices and reviews all current and bad debt accounts for adjustments as appropriate.
Ensures appropriate identification, prioritization, and timely filing of probate estate liens as for deceased patients.
Reviews settlement offers and approves as appropriate.
Researches and resolves complex issues associated with patient accounts. As applicable, identifies, documents, and reports problematic trends to leadership.
Runs report and analyzes data for potential intake errors causing incorrect data pull. Includes the correction of any such errors prior to rerunning reports for review of appropriateness of contract account billing. Educates any intake errors to appropriate department. Prepares and mails all invoices. Monitors monthly contract accounts for payment.
Reviews nursing home correspondence for potential care overlap and the appropriateness of billing Medicare vs. the nursing facility. Ensures proper billing to nursing facility if applicable.
Identifies opportunities for account consolidation and takes the necessary steps to combine appropriate accounts.
Processes and tracks all payroll deduct activity.
Processes credit card transaction payments on accounts.
Performs other related work as required or requested.