Job Summary: Responsibilities include follow-up performed on insurance and or third party account receivables to ensure payment is received from insurance company within federal, government timelines. Communicates clearly and efficiently by phone and in person with insurance companies, clients. Patients, and staff members. Maintains productivity standards and submit required daily reports which also includes, top 20 weekly report and daily productivity tracking report. Obtains updated demographic information and all necessary information needed to comply with insurance billing requirements. Responsibilities also include utilizing follow up matrix to ensure timely follow-up on aged receivables. Work denial and rejection report daily in it’s entirety. Complete cash report review to resolve all residual balances owed by primary, secondary, tertiary, and or patient. Document accounts with clear and concise notes as it relates to follow up. Request rebills when necessary and work with other internal departments as it relates to coding, registration and other ancillary services. Quality assurance results should be greater than 90% on a monthly basis to ensure proper follow up on assigned inventory. Other duties as assigned or needed.
Demonstrates Competency in the Following Areas:
· Strong interpersonal/public relations skills.
· Ability to work effectively with a wide range of customers in a diverse environment.
· Knowledge of Medicare, Medicaid, Commercial and HMO payers.
· Ability to perform analytical problem solving.
· Ability to perform basic math.
· Ability to operate concurrently within a variety of hospital systems.
· Working knowledge of PC applications, Word, Excel, etc.
· Keyboarding skills.
· Knowledge of organizational structure, workflow, and operating procedures.
· Strong oral and written communication skills.
· Organization and time management skills.
· Ability to follow directions and establish priorities effectively.
· Self-directed and capable of working without direct supervision.
· Dependable in both production and attendance.
· Demonstrates the ability to be flexible, organized and function well under stressful situations.
· Maintains performance improvement activities for the department.
· Documentation meets current standards and policies.
· Provides education to staff on performance improvement. Ability to plan and organize orientation and in-service training for department staff members. Participates in guidance and educational programs.
· Performs management activities including interviewing, hiring, evaluating, termination and departmental staffing scheduling.
Professional Requirements:
· Adheres to dress code, appearance is neat and clean.
· Completes annual education requirements.
· Maintains regulatory requirements, including all federal, state, local regulations and accrediting organization standards related to the Medical Surgical Unit and, as appropriate, to the hospital.
· Maintains and ensures patient confidentiality at all times.
· Reports to work on time and as scheduled; completes work within designated time.
· Wears identification while on duty.
· Attends annual review and performs departmental in-services.
· Maintains standards of professional society procedures and ethical behavior.
· Works at maintaining a good rapport and a cooperative working relationship with physicians, departments and staff.
· Represents the organization in a positive and professional manner.
· Attends committee, and management meetings, as appropriate.
· Resolves staff concerns at the departmental level, utilizing the grievance process as required.
· Ensures compliance with policies and procedures regarding department operations, fire safety, emergency management and infection prevention and control.
· Effectively and consistently communicates administrative directive to staff and encourages interactive departmental meetings and discussions.
· Complies with all organizational policies regarding ethical business practices.
· Communicates the mission, ethics and goals of the facility, as well as the focus statement of the department.
Regulatory Requirements:
· High school graduate or equivalent required.
· Preferred post-secondary education, i.e., Associate Degree in healthcare or business-related field.
· Bilingual capability (English/Spanish) desired.
Language Skills:
· Able to communicate effectively in English, both verbally and in writing.
· Additional languages preferred.
· Strong written and verbal skills.
Skills:
· Basic computer knowledge.
Physical Demands:
· For physical demands of position, including vision, hearing, repetitive motion and environment, see following description.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- ICD-10: 1 year (Preferred)
Ability to Commute:
- Hillsboro, TX 76645 (Required)
Ability to Relocate:
- Hillsboro, TX 76645: Relocate before starting work (Required)
Work Location: In person