Thank you for your interest in joining our team! Please review the job information below.
General Purpose of Job:
This position reports to the Patient Access Services Manager. This position is responsible for the support functions necessary to accomplishing the objective of the department. These include, but are not limited to functions under the categories of: patient accounting, insurance and patient account follow up, variance reconciliation and coordination of benefits, reimbursement verification, and appealing denials.
Essential Duties and Responsibilities:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or hospital administration as required.
Maintains utmost level of confidentiality at all times.
Adheres to hospital policies and procedures.
Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
Adheres and complies with customer service standards and dress code as set forth by the hospital and the department.
Customer Service Duties
Answers the department telephone immediately or within three rings utilizing courtesy and patience.
Greet patients and their families with courtesy and concern for their needs.
Listens to customer needs and takes appropriate action as indicated.
Document telephone encounters.
Work with our outside collection vendors to resolve account issues as indicated.
Patient Financial Services Duties
Financially screen patients for medically needy program as assigned.
Follow up with patients as necessary to finalize medically needy determinations.
Document HHSC determinations and update patient accounts as indicated.
Resolve any billing issues to ensure appropriate reimbursement that is expected.
Review patient demographic and financial data to ensure accuracy.
Validate payer information is accurate and in the correct billing order for accurate reimbursement.
Work to resolve disputes between the insurance subscriber or member and their insurance company.
Manage denial appeals as indicated.
Create and maintain referral records and group to Auth cert records within EPIC.
Quality Assurance Duties
Review patient accounts to ensure proper policy and processes are followed.
Identify patients with multiple same day visits to combine accounts when applicable.
Review and validate billing process to ensure Federal and state guidelines are followed.
Review and validate cashier process to ensure appropriate reconciliation.
Verification and documentation of insurance eligibility and coverage for anticipated procedures.
Work with clinical case management to identify accounts or payers that are not reimbursing appropriate to the authorization.
Education and/or Experience:
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
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