To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Responsible for collecting self pay balances and retrospectively reviewing potential bad debt accounts prior to turnover. Contacts patients and/or third party carriers in order to collect accounts to maximize cash flow and reduce bad debt. Takes appropriate action to resolve account balances and collect self pay balances while ensuring the hospital's image of good customer relations is maintained at the highest level. Reviews payment of claims on remittances to ensure maximum third party reimbursement of accounts to correctly identify self pay balances. Makes assessment of financial status to determine course of action. Discusses patient payment options and obtains credit card payments from patients over the telephone. Advises patient of Free Care and Discounted Care options, initiating the process when appropriate. Refers self pay accounts for turnover to agency/attorneys. Complies with all HIPPA verification procedures to identify patient/appropriate party prior to providing information.
- 1. Audits accounts in self pay file to insure accuracy of balance and makes timely demand for payment of account.
- 1.1 According to established guidelines, performs "matching" function to combine self pay balances for a particular guarantor to be worked together.
- 2. Works with patients and/or representative to determine if a settlement can be reached regarding an account, advises supervision when necessary to approve terms. Refers all accounts without prospect of voluntary payment to the next level of collections within established time frames with all necessary information for turnover documented in the system.
- 2.1 Contacts patient to arrange payment in full or installments in accordance with credit card collection policy and established guidelines. Verifies the identity of patient/appropriate party prior to providing information in order to be HIPPA compliant.
- 3. Uses established follow up procedures to effectively expedite the prompt payment of claims by third parties and self pay patients. Recognizes problem areas and trends which deter the follow-up or collection effort and effectively communicates these to the supervisor.
- 3.1 Utilizes the computer system to access daily work file to identify accounts requiring follow up activity.
- 4. Analyzes correspondence and problems as they pertain to accounts and takes corrective action to ensure proper maintenance of account and facilitate payment.
- 4.1 Reviews and responds to internal and external mail/data/electronic mail within five (5) working days of receipt and returns telephone calls within 24 hours or the next working day.
- 5. Keeps abreast of changing federal, state and insurance regulations and the guidelines to capitated and managed care contracts in a dynamic healthcare environment as well as credit and collection policies and charity care regulations. Keeps informed on policies and procedures pertaining to the credit reporting process. Reviews all memo and policy updates regarding per diem rates, DRG payment, percentage payments, case rate payments, and various UB04 revenue codes and any combination of these plans as well as the fee for service payment contracts, as they are distributed by the supervisor, to ensure currently billing procedures are followed. Maintains knowledge of general bankruptcy information and key federal bankruptcy codes.
- 5.1 Accepts responsibility to maintain/update follow up/collections procedures pertaining to third party, state and federal billing and payment regulations and other contract guidelines and credit and collection policies and regulations.
High school graduate with courses in Business, Associate's degree in a Business related field preferred, or equivalent work experience.
Two (2) to three (3) years experience in hospital/healthcare computerized accounts receivable environment or 3 years comparable collection environment necessary.
Ability to communicate effectively with patient/third parties to obtain payment. Knowledge of third party insurance carriers and their billing and reimbursement requirements. Excellent analytical and mathematical skills with a high degree of accuracy. Ability to perform detailed analysis quickly and accurately. Knowledge of general bankruptcy information and key federal bankruptcy codes, Free Care and credit and collection guidelines. PC skills including Microsoft Office.