PATIENT ACCOUNTS REP

Job Description

Responsibilities

Patient Account Representative

Del Amo Behavioral Health System, a subsidiary of UHS ,offers a safe and compassionate environment for individuals looking for hope and healing from emotional, psychiatric and addiction issues.

Del Amo Behavioral Health offers a wide range of options, including inpatient, outpatient and specialty programs that includes children, adolescents, adults and seniors. Whether addressing the needs of adults, adolescents or children, we are committed to providing our patients with treatment to help them find recovery that endures. Our patients receive the same quality treatment from our thoughtful and compassionate team no matter the level of care.

Learn more and apply today by visiting our website at:

About Universal Health Services

One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune corporation, UHS today has annual revenue nearing $ billion. UHS is recognized as one of the World’s Most Admired Companies by Fortune; ranked # on the Fortune , and listed # in Forbes inaugural ranking of America’s Top Public Companies.

JOB DESCRIPTION

The Patient Accounts Representative exists to verify all patient account insurance information on the day of admission or the next working day. Contacts the patient’s and/or third party payer organization(s) to secure insurance benefits and information. Secures all self-pay deposits and payment while patients are in the facility.

PRIMARY CRITERIA/RESPONSBILITIES:

• Knowledgeable of all payers and billing/payment practices.
• Knowledgeable of collections procedures and schedules.
• Receives all over-the-counter and mailed payments.
• Prepares bank deposits and posts payments.
• Reviews explanation of benefits and applies contractual adjustment accordingly.
• Prepares daily cash reports.
• Prepares and submits refund requests to Business Office Director for approval.
• Consistently reviews all information received daily from the Intake Department with regards to insurance, demographics and payment arrangement information.
• Consistently reviews any delinquent insurance information and reports to the Business Office Director any self-pay accounts in the house as a result of no insurance.
• Consistently contacts all third party payers and other appropriate persons, such as patients themselves, to obtain additional information or clarification regarding patient insurance information.
• Consistently follows department policies and guidelines in obtaining, reviewing and settling delinquent information.
• Regularly investigates apparent trends or patterns of delinquent patient information and reports to the supervisor and co-workers on the pertinent findings.
• Demonstrates proficiency in applying proper and effective account investigation/analysis and settlement techniques in performing job functions.
• Consistently follows up on problem delinquencies and develops recommendations for their proper disposition within three (3) days of their identification as a problem.
• Consistently obtains appropriate additional information, clarification regarding insurance or third party information to ensure the initiation of the proper follow up action.
• Consistently responds to inquiries from Hospital personnel regarding current information relating to the patient insurance information.
• Verifies all insurance information on all admissions for the last hours.
• Always uses proper tact and discretion in handling inquiries and account settlement discussions with patients and their families.
• Consistently prepares all tars for review and signature for utilization review and physicians within the allotted time frame to ensure proper payment for a future date.
• Copies medical records required to go with TAR.
• Enters all MIS information into the system within hours of the admission to ensure timeliness.
• Prepares all cross-over Medicare billing.
• Demonstrates a thorough knowledge and understanding of admitting procedures and the collection of proper information thereof in performing job duties and explaining insurance information to patients and third party payer organizations.
• Accurately reclassifies accounts within hours of insurance verification if appropriate and brings to the attention of the Business Office Manager if there are any delinquencies.
• Obtains and analyzes all pertinent information available in order to make the most informed decision based on factual and objective data.
• Demonstrates an understanding of the legal avenues available for facilitating the settlement of problem delinquencies.
• Consistently prepares recommendations for the referral of delinquent information to the Business Office Manager in a timely manner to facilitate their resolution.
• Consistently provides appropriate and logical justification for account disposition and recommendations.
• Consistently provides statistic information regarding information status and disposition reports in accordance with established schedules.
• Demonstrates knowledge to assemble and maintain records appropriately in order to increase overall efficiency to maximum potential.
• Consistently maintains census activity records in an organized manner.
• Always ensures the accuracy and completeness of records.
• Reviews all department insurance verification policies and procedures annually to maintain current knowledge level and proficiency in the department’s operating guidelines.
• Regularly reviews legislation effective to all third party reimbursement to remain aware of any pertinent changes in allowances or requirements.
• Demonstrates proficiency in automated systems including: MIS, PBX, Copy Machine and Fax Machine.
• Demonstrates understanding of utilization review systems including eligibility, authorizations, benefits and collections.
• Answer phones and cover the receptionist when needed. Ensures all who enter complete the COVID- Health Screening Form (screening form); assists with completion as needed.Takes the temperature of all who enter and logs temperature on the screening form.Reviews the form to verify if any one entered if someone answered “Yes” to being out of the country.Contacts the House Supervisor when there are positive screens for travel, close contact risk factors, positive COVID test, or fever > °F; seeks assistance when necessary.Maintains proper boundaries when interacting with patients, staff and visitors.Ensures only authorized personnel are admitted onto facility premises.
• Demonstrates and is knowledgeable of the following policies and procedures for disaster and alarm response:a) Who to call; b) Checklist; c) Fire Department notification; d) House Supervisor notification; e) Triage procedures.
• Performs additional duties as requested.

Qualifications

Job Requirements

Education: High School Graduate or Equivalent required.

Experience: Previous training in insurance verification required. Two years insurance collections in a hospital setting required.

KNOWLEDGE/SKILLS:

• Effective telephone techniques and listening skills required.
• Working knowledge of insurance terms, reimbursement procedures, medical terminology and hospital services, rates and policies relating to collection activities required.
• Must be able to perform assignments with minimal supervision;
• Must be able to perform concentrated and/or complex mental activity with frequent involvement in complex and/or highly technical situations;
• Must be able to work successfully under highly stressful conditions;
• Must be able to make sound, independent judgments based on scientific and/or ethical principles;
• Must be able to comprehend and perform oral and written instructions and procedures;
• Must be able to collaborate with other multidisciplinary team members in an appropriate fashion;
• Must be capable of adapting to varying workloads an work assignments on a constant basis;
• Must have effective comprehensive reading skills, strong communication skills, written and verbal.
• Must possess a valid California Driver’s License in order to drive hospital vehicles or on hospital business.

MINIMUM REQUIREMENTS OF THE POSITON:

• Must be able to demonstrate special training, knowledge and skills specific to job specific competency within three (3) months of hire date.
• Must complete all required mandatory inservices annually.
• Must be tested for Tuberculosis with a PPD skin test or chest x-ray upon hire; PPD skin test required annually or chest x-ray tri-annually thereafter.
• Must adhere to facility and department policies and procedures and comply with the Corporate Compliance Program and Standards of Conduct.