Position Summary:

Responsible for accurate and timely verification of benefits, financial counseling, identifying patients financial responsibility, helps assist patients with filing for assistance and identify charity. Works closely with Intake. Employee must have solid understanding of insurance contracts. Strong analytical skills, the ability to work unsupervised, proficient in Microsoft Excel, a strong attention to detail and exceptional work ethic.

This position requires a comprehensive understanding of accounts receivable management in a healthcare setting. Strong customer service, organizational and communication skills are essential to this position. In addition, strict adherence to Patient Accounts policies as outlined in the Procedure Manual is required. This position requires an ability to prioritize multiple tasks simultaneously in an occasionally stressful environment. Also required are general computer skills, typing skills and a working knowledge OSHA and HIPAA guidelines.

Position Responsibilities:

Clinical / Technical Skills (40% of performance review)

• Validates insurance information of patients for accuracy and completeness and resolve discrepancies as needed.
• Collects co-pay, deductible and out of pocket expenses from patient at time of admission meeting the upfront collections success rate
• Update and maintains Front end log
• Verify all active clients Medicaid and Medicaid HMO on the first of each month
• Assist patients with filing for financial assistance.
• Follow-up on in-house payment plans effectively
• Perform data entry utilizing Electronic Medical Record for documentation of insurance information with minimal errors
• Effectively transfers and maintains early out and bad debt accounts/inventory
• Analyze patient data, from admission through discharge, to ensure that all key elements that affect billing and collections represent and accurate.
• Provide patient notifications to patients or patients representatives including End of Coverage Notifications, Recertification application, and any other payor required documents
• Identify and recommend process improvements-based job functions.
• Maintains HCS emails and responds timely and professionally
• Knowledgeable insurance benefits, covered services and billing procedures of all Government and non-Government insurance programs.
• Ability to obtain single case agreements with non-contracted insurance companies.
• Ability to determine patient financial responsibility based on payor guidelines.
• General knowledge of office procedures and ability to utilize resources in an organized manner.
• Must have ability to make independent decisions and exercise discretion when working with patients and insurance companies.
• Attention to detail, follow through on tasks, problem solve, trouble shoot and be able to multi-task in a fast-paced environment.
• Ability to discuss personal and financial matters with patients and/or their representatives regarding credit and collection policies and procedures.

• Performs other duties as assigned

Safety (15% of performance review)

• Strives to create a safe, healing environment for patients and family members
• Follows all safety rules while on the job.
• Reports near misses, as well as errors and accidents promptly.
• Corrects minor safety hazards.
• Communicates with peers and management regarding any hazards identified in the workplace.
• Attends all required safety programs and understands responsibilities related to general, department, and job specific safety.
• Participates in quality projects, as assigned, and supports quality initiatives.
• Supports and maintains a culture of safety and quality.

Teamwork (15% of performance review)

• Works well with others in a spirit of teamwork and cooperation.
• Responds willingly to colleagues and serves as an active part of the hospital team.
• Builds collaborative relationships with patients, families, staff, and physicians.
• The ability to retrieve, communicate, and present data and information both verbally and in writing as required
• Demonstrates listening skills and the ability to express or exchange ideas by means of the spoken and written word.
• Demonstrates adequate skills in all forms of communication.
• Adheres to the Standards of Behavior

Integrity (15% of performance review)

• Strives to always do the right thing for the patient, coworkers, and the hospital
• Adheres to established standards, policies, procedures, protocols, and laws.
• Applies the Mission and Values of SUN Behavioral Health to personal practice and commits to service excellence.
• Supports and demonstrates fiscal responsibility through supply usage, ordering of supplies, and conservation of facility resources.
• Completes required trainings within defined time periods, as established by job description, policies, or hospital leadership
• Exemplifies professionalism through good attendance and positive attitude, at all times.
• Maintains confidentiality of patient and staff information, following HIPAA and other privacy laws.
• Ensures proper documentation in all position activities, following federal and state guidelines.

Compassion (15% of performance review)

• Demonstrates accountability for ensuring the highest quality patient care for patients.
• Willingness to be accepting of those in need, and to extend a helping hand
• Desire to go above and beyond for others
• Understanding and accepting of cultural diversity and differences

Education

• Required: High school diploma or GED. Basic medical terminology
• Preferred: Bachelors degree in healthcare or business-related field
• Maintains education and development appropriate for position

Experience

• Required: One to two years previous experience in related field. Knowledge of insurance payor rules and regulations.
• Preferred: Understanding of behavioral health treatment modalities. Working experience in HCS system a plus