Bargaining Unit: Non-Represented

Rate of Pay: $28.36 + DOE

Summary:

• Performs all duties of a Patient Account Representative.
• Assists in allocating accounts to patient representatives.
• Ensures that Return to TFHD for Assistance Work Queues are being worked timely for all external resource vendors (CMRE, NOVUS and IRRG and others as might be added).
• Ensures that all logs for Financial Customer Services and Financial Counselors are completed and returned.
• Ensures all grant accounts have appropriate payments and works with the departments to ensure patient eligibility.
• Ensures all secondary commercial claims are billed within twenty-one (21) days of primary payment receipt.
• Ensures representatives appropriately complete payer-specific documents.
• Communicates directly with payers to follow up on outstanding claims, resolves payment variances, and achieves timely reimbursement.
• Communicates directly with external departments and patients to follow up on outstanding claims, resolves payment variances, and achieves timely reimbursement.
• Oversees special projects developed by department management.
• Acts as a resource for day-to-day operational questions.
• Maintains a thorough knowledge of federal and state regulations, payer specific requirements.
• Functions as a super user in the department’s systems and maintains knowledge of all procedures. Assists with training staff.
• Functions as a first contact for external departments. (Financial Customer Service, financial counseling, and HIM).
• Communicates with the Manager PFS, other department leaders, insurance carriers, patients, providers and/or other billing personnel to ensure a smooth workflow.
• Independently prioritizes the work of others in identified problem areas.
• Acts as first resource for staff for urgent and emergent needs when manager is unavailable.
• Refers persistent problems to management.
• Assists with developing team members through group, as well as one-on-one training and in-services.
• Thoroughly documents all interactions with payers.
• Identifies high-risk accounts, and prioritizes follow-up efforts.
• Responsible to be a knowledge resource related to workflow operations and the inner workings of the Health Information System (HIS) and supporting systems Recommends streamlined workflow resolutions, as appropriate.
• Monitors quality and productivity levels for both individual staff members and the team as a whole; identifies and re-trains underperforming staff members as needed.
• Participates in quality improvement efforts on an ongoing basis, establishing goals with leadership and tracking goal progress.
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
• Understands and maintains compliance with HIPAA guidelines when handling patient information
• Orders supplies and places IT tickets.
• Demonstrates System Values in performance and behavior.
• Performs other duties as assigned.
• Complies with System policies and procedures.

Qualifications:

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.

Supervisory Responsibilities:

No Supervisory Responsibilities

Minimum Education/Experience:

No educational requirements and 2 - 3 years relevant experience

Required Licenses/Certifications:

None Required

Other Experience/Qualifications:

Required:

• Conducts themselves as a professional and is viewed as a role model
• Accurate data entry skills

Preferred:

• Healthcare Financial Management Association (HFMA) Certified Revenue Cycle Representative (CRCR) certification

Computer/Business Skills:

Ability to use office machines. Demonstrated ability to use word processing and other Microsoft Office programs.