Fin Assessor SBO Patient Acctg

The Fin Assessor SBO Patient Accounting reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.

Responsibilities:

• Timely resolution of all claim edits and management & reporting of candidates for bill.
• Outbound compliant bill submission clinical documentation requirements and any other communication required (verbal or written) regarding claims ensuring timely filing of claims and clean complete and accurate claims.
• Timely follow-up and collection of third party payer receivables and tracking of third party yields.
• Denials and Appeals resolution including root cause analysis to reduce/prevent future denials while working to overturn denials for payment resolution.
• Compliant follow-up correspondence to third party payers regarding outstanding accounts receivables (i.e. Statements letters e-mails faxes portal mail etc.).
• Adhere to all regulatory billing requirements reporting any suspected breaches or concerns to the Patient Accounting Manager and Corporate Integrity & Compliance (HIPAA Patient Privacy and ACA Consumer Protections).
• Consistently meet the current productivity and quality standards in edit resolution account follow-up payment processing activities including payment posting reconciliation and refunds handling high volume of phone calls including wrap up time between calls ready status/availability for calls and timely handling of patient concerns and correspondence while maintaining the Patient First philosophy.
• Receive and direct the public in person or by telephone in a professional and courteous manner.
• Answer patient inquiries with the objective of resolving the patient issue in one call or directing inquiries to the appropriate representative if the issue cannot be resolved immediately.
• Enter appropriate documentation of all account activity.
• Provide clerical support to the management and supervisory staff as needed.
• Manage early-out vendor return accounts as outlined in the NMHC Self-Pay Collection Procedure.
• Coordinate communication with early-out vendor staff regarding patient accounts concerns and complaints as outlined in the NMHC Self-Pay Collection Procedure.
• Enter appropriate documentation of all new insurance information to restart the billing and follow-up cycle as appropriate.
• Respond to patient payor and employee inquiries regarding hospital and professional balances financial assistance applications and both hospital and clinics visits as they relate to the SBO.
• Demonstrate excellent customer service through oral and written communication in providing assistance/expertise to patients authorized guarantors and other external and internal contacts.
• Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
• Seamlessly transition patient calls to and from early out vendor staff as required.
• Provide individual contribution to the overall team effort of achieving the department accounts receivable goals.
• Identify opportunities for customer system and process improvement and submit to management.
• Demonstrate proficient use of systems and execution of processes in all areas of responsibilities.
• Follow the NMHC general Policy and Procedures the Departments Policy and Procedures and any Emergency Preparedness Procedures.
• Follow JCAHO and outside regulatory agencies mandated rules and procedures.
• Utilize assigned menus and pathways in the hospital mainframe system and report software application problems to the appropriate supervisor.
• Utilize assigned menus and pathways in external software applications and report software application problems to the appropriate supervisor.
• Utilize assigned computer hardware and report hardware problems to the appropriate supervisor.
• Participate in the testing for assigned software applications including verification of field integrity.
• Assist the Operational Coordinator and Team Lead Financial Assessor with special projects and other duties as assigned as necessary.
• Attend training and seminars as assigned and approved by the Customer Service Coordinator.

AA/EOE.

Qualifications :

Required:

• High school diploma.
• 1 year of related work experience or college degree.
• Working knowledge of physician and facility billing and follow-up including understanding of insurance rules and regulations especially Medicare and Medicaid.
• Knowledge of HIPAA standards.
• Ability to perform mathematical calculations.
• Excellent communication skills when dealing with patients families public co-workers and professional offices.
• Basic knowledge of medical terminology and billing practices.
• Extensive experience and knowledge of PC applications including Microsoft Office and Excel.
• Ability to:
  • Learn quickly and meet continuous timelines.
  • Exhibit behaviors consistent with principles of excellent service.
  • Demonstrate and maintain competency as required for job title and the unit/area(s) of assignment.
  • Exhibit behaviors consistent with standards of performance improvement and NMHC values.

Preferred:

• 2 years of college or college degree.
• Call center or telephone work experience.
• Knowledge of Epic Systems.
• Two (2) years of progressive work experience in a hospital/physician billing or SBO environment.
• Detail-oriented good organizational skills and ability to be self-directed.
• Strong time management skills managing multiple priorities and a heavy workload in a high-stress atmosphere.
• Flexibility to perform other tasks as needed in an active work environment with changing work needs.
• High-level problem solving analytical and investigational skills.
• Excellent internal/external customer service skills.
• Excellent communication skills to include oral and written comprehension and expression.

Additional Information :

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age sex race color religion national origin gender identity veteran status disability sexual orientation or any other protected status.

Benefits

We offer a wide range of benefits that provide employees with tools and resources to improve their physical emotional and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more.