Patient Collections
Job Type
Full-time
Description

  

The Patient Collections Billing Specialist position is expected to meet all organizational payment collections performance expectations. The Patient Collections Specialist is a highly skilled, multi-tasking position that incorporates one-on-one patient communication, collections on patient balances, and debt reconciliation for past-due amounts. The Patient Collections Specialist Collector may also function as an intermediary between healthcare providers, clients, patients and health insurance companies. This position works closely with other collectors, coders, payment posters, and insurance follow-up specialists in completing collection activities while maintaining proficient results, accuracy, and excellent customer service.
Requirements

    

Essential Duties/Responsibilities:

· Takes payments by collecting patient balances due

· Handles and routes inbound patient collection calls as assigned in a professional and courteous manner.

· Answers billing inquiries from patients and practice staff.

· Batches and sends patient statements both electronically and paper.

· Works returned mail.

· Uses worklist reports to determine a follow-up schedule for contacting patients regarding outstanding accounts.

· Prepares patient collection letters.

· Arranges for debt repayment and/or establishes repayment schedules, based on customer’s financial situations.

· Reviews and responds to all bankruptcy notices and court requirements.

· Maintains documentation of accounts to be placed with collection agency.

· Perform various administrative functions for assigned accounts, such as recording address changes and purging the records of deceased customers. 

· Maintains advanced knowledge of physician billing and accounts receivable systems.

· Meets department production standards consistently as defined by department management.

· Maintains working knowledge of the EMR and clearinghouse systems along with any technology needed for the position.

· Meets department production standards consistently as defined by management.

· Other duties as assigned and/or requested by your supervisor or management.


Required Knowledge/Skills/Abilities: 

· Excellent working knowledge of bill collection strategies, insurance payers, and the A/R revenue billing lifecycle.

· Knowledge of reimbursement methodologies and procedures associated with each payer type including: HMO, POS, PPO, Indemnity.

· Knowledge of arithmetic and mathematical applications.

· Knowledge of CPT, ICD-9, and ICD-10 codes.

· Knowledge of Medicare Parts A and B insurance and reimbursement procedures.

· Knowledge of office policies and procedures to accurately answer questions from staff, physicians, and patients.

· Knowledge of administrative and clerical procedures and systems such as word processing, Microsoft Office, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.

· Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.

· Knowledge and correct usage of medical terminology.

· Ability to navigate and effectively use EMR, practice management system, and clearinghouse. Knowledge and experience with Epic EMR system is preferred.

· Ability to reach and understand explanation of benefits statements.

· Ability to council patients financially regarding outstanding charges & effectively resolve issues at the highest level of customer service.

· Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations.

· Ability to maintain confidentiality and professionalism.

· Ability to effectively and clearly communicate in writing, over the telephone, and in person with physicians, office staff, and patients.

· Ability to work as part of a team and promote a positive work environment.

· Ability to listen and understand information and ideas and adjust actions accordingly while exercising independent judgement.

· Ability to comply with all facility policies, procedures, and practices, and follow directions from supervisor.

· Ability to maintain professional attire and report to work on time/as scheduled.

· Ability to complete continued education/training requirements as requested.

· Ability to represent the organization in a positive and professional manner at all times / Ability to communicate the mission, ethics and goals of the organization.

· Ability to apply feedback, participate in performance improvement, and continuous quality improvement activities.

· Skilled in reviewing health care delivery against established guidelines for accurate and timely payment posting.

· Skilled in organization, attention to detail, and task prioritization.

· Skilled in ability to exercise independent judgement and ability to proactively look for ways to help people.

· Skilled in using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

· Skilled in understanding patient needs to provide exceptional customer service.


Education and Experience:

· High school diploma or GED required, associate's degree or higher preferred.

· 2-3 years of experience in Physician Billing Revenue Cycle and Central Business Office setting.

· Experience and understanding of different payer types and EOBs.

· 2-3 years of experience working in patient collections.