RCM Patient Accounts Specialist

The RCM Patient Accounts Specialist position works under the supervision of the Revenue Cycle Manager. This position is responsible to follow patient accounts through the entire billing process from eligibility to completion of the payment process. The Patient Account Specialist verifies eligibility and benefits requests payments and resolves account issues. The position is also Primary in customer service in answering phone calls and fulfilling these duties the incumbent performs the following duties independently:

• Verifies patient eligibility and/or benefits via the phone or website(s) follows up with patient and health plan to determine that the patient is covered;
• Handles person-to-person patient inquiries regarding billing issues;
• Contacts patients for payment requests overdue payments denied claims and arrange payment plans;
• Respond to and submit refund requests
• Be primary back up for the RCM Payment Data Entry Specialist;
• Responsible for maintaining daily account follow-up work lists within department while maintaining organizations productivity standards;
• Responsible for identifying researching and resolving: credit balances missing payments and unposted cash as it pertains to billing account follow-up.
• Audit patient accounts;
• Handle collections on unpaid accounts;
• Provide outstanding customer service both internally and externally;
• Answers telephone calls and direct calls appropriately;
• Approve clients for Sliding Scale or funding;
• Apply clients for available funding. Provides Good Faith Estimates when required;
• Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation;
• Maintains current knowledge of internal industry and government regulations as applicable to assigned function;
• Establishes and maintains professional and effective relationships with peers and patients;
• Maintains strictest confidentiality; adheres to 42 CFR part 2 and all HIPAA guidelines/regulations;
• Able to problem solve issues and apply them to daily problems that occur;
• Understanding of Patient Statement Systems responsible for sending statements in a timely manner;
• Appropriately communicate written and verbally with insurance companies patients co-workers and supervisors;
• Must be able to prioritize tasks to meet multiple deadlines and productivity requirements;

• Will work as part of a Revenue Cycle Management team;
• Supports and implements agency policies and procedures;
• Performs special projects as assigned by supervisor.

KNOWLEDGE AND SKILLS REQUIRED BY THE POSITION

• Possess two years experience in medical/non-profit billing and collections;
• Possess two years experience in customer service;
• Requires a detailed understanding of insurance billing Medicaid billing in Provider One ICD-10/CPT codes HCFA 1500 UB-04 and an understanding of insurance requirements for payment;
• Medical Billing certification or degree preferred;
• Prior experience with Qualifacts CareLogic electronic health record preferred;
• Ability to produce accurate information and reports using Microsoft Excel
• Great attendance;
• Ability to work well with others;
• Must be highly organized detail oriented possess good analytical skills effective verbal and written communication skills and be able to work well under pressure.

GUIDELINES

Requires that the incumbent relies on specialized training and/or equivalent experience and performs duties in accordance with Washington Administrative Codes Federal regulations governing the confidentiality of patient files and Lifeline Connections Policy and Procedure Manual.

PERSONAL CONTACTS

Contacts are with the members of the treatment team consumers significant others of the consumers representatives of various community agencies specializing in the treatment of chemical abuse and mental illness and related community representatives including lawyers. All personal contacts are carried out in accordance with federal and state laws dealing with the confidentiality of patient records.

PHYSICAL DEMANDS

While performing the essential functions of the job the employee is regularly required to sit speak clearly hear and use hands and fingers to manipulate writing utensils and keys on a keyboard.

WORKING ENVIRONMENT

Working hours are spent indoors in offices or other meeting rooms. Participation in staff retreats and staff development activities will be required.

IMMEDIATE SUPERVISOR: Revenue Cycle Management Supervisor