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Patient Accounting Representative

Job Code:  94752
Facility: Belmont Pines Hospital
Location: YOUNGSTOWN, OH US
Region:
Travel Involved: 0-10%
Job Type: Full Time
Job Level:  Experienced (Non-Manager)
Minimum Education Required: High School or equivalent 
Skills:  
Category: Support
FTE: 1
Position Summary:
POSITION SUMMARY
Insurance verification. Responsible for financial assessment of patients, determination of ability to pay, collection of deposits, negotiation of payment arrangements, securing financing of self-pay liability, identification of funding sources, some tracking, monitoring and reporting requirements. Responsible for billing of claims and third party insurance. Billing system maintenance and identification of problem or uncollectible accounts as required. Maintains patient financial file. Advises, informs, and assists the patient/guarantor/family in regard to hospital financial policies. Maintains patient privacy and confidentiality. Performs other duties as needed.

PRIMARY RESPONSIBILITIES

1. Follows hospital and departmental policies and procedures.
2. Demonstrates cooperation with fellow employees, patients, and staff.
3. Documents every contact made to or by third party payer, patient family, or employee.
4. Enters all admissions and discharges daily.
5. Updates Census information daily in all areas.
6. Enters all ancillary charges daily.
7. Verifies all demographic information.
8. Reviews assessment to determine information to be entered and enters it.
9. Updates Net Revenue report to reflect admission, discharge, service, and insurance information including any corrections to previously entered data.
10. Identify additions and changes to the hospital Charge Master.
11. Maintain accurate records for the Residential Unit, especially the therapy units, account numbering, admissions, and discharges.
12. Manages office purchasing and supplies.
13. Maintains patient financial folders, if applicable.
14. Keep patient files and contents in uniform and orderly manner.
15. Maintains neat, legible, and chronological documentation of all collection and follow-up activity.
16. All requests for Insurance Verification are responded to in a timely manner to facilitate admission.
17. Requests for Verification of Benefits for all levels of care are responded to immediately.
18. All benefit and eligibility information is completely documented with accuracy and detail.
19. Benefit and eligibility information is conveyed to designated staff on a timely basis.
20. Written confirmation of benefits and eligibility is obtained as directed.
21. Accurate third party and self-pay liability must be determined.
22. Knowledge of benefits, anticipated lengths of stay, average program cost must be determined to establish correct liability.
23. Written out of pocket estimates must be prepared and discussed with patient and/or family.
24. Administrative Approval forms will be prepared and routed for approval on a timely basis.
25. All patients will be “financially secured” as soon as possible, but no later than at discharge.
26. Financial statements will be obtained as necessary to assess ability to pay.
27. Credit reports will be requested to assist in determining collectibility.
28. Proof of income and expenses will be requested, when deemed necessary, to verity financial statements data.
29. Financial Counseling will be performed as needed to assist patients in identifying funding sources.
30. “Advance Payments” will be collected according to guidelines provided.
31. Written payment agreements, either in-house or loan program, will be obtained on all patients with an unpaid liability remaining at discharge.
32. Responsible for performing follow-up on assigned accounts according to established guidelines.
33. Contact each Guarantor within 24 hours of admission during weekdays and within 72 hours of weekend admissions if applicable.
34. Maintains appropriate reminder system for follow-up activity.
35. Performs third party and self-pay follow-up as required.
36. Advises Business Office Director on a timely basis of potential problem accounts.
37. Bills third party insurance including electronic submission of claims within five days after a patient’s discharge.
38. Checks all bills and UB-92s for accurate information routinely.
39. Checks insurance verification routinely before billing.
40. Checks for additional information when billing (claim forms, EOBs, Medical Records, etc.).
41. Log all billing information in HMS System.
42. Knowledge of specific billing requirements of various carriers (i.e., Medicare, Champus, Medicaid, etc.).
43. Timely bills all secondary insurance and refiles any missing or lost bills in a timely manner.
44. Bills any outstanding late charges and request bills to reflect late charges.
45. Utilizes electronic billing system effectively. Routinely checks billing statutes and Medicare eligibility and psyche day’s limitations.
46. Performs any other duties as assigned by the Business Office Director.
47. All data input within one working day of charge generation.
48. Prepare and balance cash packet daily.
49. Accurately post payments to patient accounts daily.

 
Requirements
QUALIFICATIONS
Education: Must have a high school diploma.
Experience: Two years prior admissions and/or collections in a hospital setting required.
Additional Requirements: Must be able to demonstrate average to high math skills. Knowledge of third party payment procedures, managed care and government programs strongly recommended. Good communication skills and ability to problem solve a must. Knowledge of credit, collection, and confidentiality laws highly desirable. Previous electronic billing experience desirable.
Personal Requirements: Must have strong written and verbal communication skills; ability to deal effectively with all levels of hospital management to the public. Ability to consult face to face with family members concerning financial matters.

PHYSICAL, MENTAL, AND SPECIAL DEMANDS

1. Ability to work at least 40 hours/week.
2. Ability to sit for long periods, up to 8 hours.
3. Ability to use both hands in fine manipulation of small tools (copier, computer,
telephone, typewriter, calculator, safe, facsimile machine).
4. Ability to push and pull up to 10 lbs. (file cabinet drawers, computer paper
boxes).
5. Ability to see well enough to read handwritten and typewritten material.
6. Ability to lift and carry up to 25 lbs. to move/transfer file boxes, data processing
paper and newly admitted patients’ belongings as required.
7. Ability to stoop, kneel, and bend daily to retrieve files from bottom shelves and
drawers and to move boxes of paper and forms to computer printer.
8. Ability to reach, turn, and twist above and below the waist.
9. Ability to stand and walk the facility grounds.
10. Ability to spend 10% of working time outside in temperatures varying from
below 0 degrees Fahrenheit to 110 degrees Fahrenheit.
11. Ability to spend 90% working time in environment of continuous low voices and office machine noise typical for business office atmosphere.
12. Ability to handle a variety of repetitive tasks at a moderate level.
13. Ability to occasionally handle electrical, mechanical, or equipment emergencies

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