Patient Financial Services Specialist II

Position Description

Application materials will be reviewed in an ongoing basis until positions are filled. Please allow up to (2) two weeks for processing of application materials. (Postmarks and faxes not accepted.) The eligible list established by this recruitment maybe used to fill current and future permanent or temporary vacancies as they arise. Exam# 23/80M02/02SS.

Examples of Duties

• Reviews, verifies, obtains and corrects patient financial status and payor source information, medical diagnosis, laboratory and other diagnostic services information, hospital/clinic services and supplies, applicable dates, required authorizations and certifications, signatures, and other information related to preparation and processing of patient bills, and eligibility for coverage
• Enters data into and operates a computerized patient account system
• Researches and resolves missing or conflicting information
• Interviews and works with patients, families, and others regarding financial resources, eligibility for coverage, status and basis of charges, payment requirements, payment plans, collections, and related matters, in person, by telephone and by letter
• Works with other service providers, claim adjudicators, insurance companies, private payors, governmental payor sources, the County Revenue Recovery Division, and others to obtain, correct or provide information; verify eligibility; process patient accounts; verify procedures; initiate collection and/or resolve disputed, unprocessed, and other claims requiring follow-up
• Assembles pre-billing materials; prepares, generates and sends individual, insurance, governmental, crossover, and other bills for medical care related services; evaluates, modifies and resubmits bills
• Evaluates and processes bad debt accounts; performs collection and follow-up activities; refers uncollectible accounts to collection services
• Requests completion of additional forms or information for denied claims or special processing requirements
• Reconciles accounts; posts payments; adjusts balances to reflect denials, adjustments, shares-of-cost, payments, and other modifications to balances; prepares refund packages for approval
• Reviews billing documentation; resolves issues that would prevent accurate, prompt claim billing
• Runs computerized reports to search for missing or conflicting information
• Troubleshoots download problems; communicates problems and recommendations to supervisor for approval
• May work in a specialty area such as pre-billing, billing, or collections

Examples of Experience/Education/Training

• Federally Qualified Health Center billing procedures and operations
• Insurance, other private workers compensation, governmental and special payor requirements, procedures, codes and forms
• Hospital/clinic billing procedures and operations
• Sources and eligibility requirements for publicly-funded medical care payment programs

• Clerical bookkeeping practices and procedures.
• General Clerical Office Practices and procedures, including operation of common office equipment and filing systems
• Current Procedural Terminology and other reference and resource materials related to patient account activities
• CPT coding procedures

• Basic Medical Terminology and/or medical billing operations.
• Personal Computer operations.

• Perform arithmetical computations, comparisons and postings rapidly and accurately.
• Perform data entry on a computer key board quickly and accurately
• Operate a 10 key adding machine quickly and accurately
• Accurately match and file materials using alphabetic and numeric systems.
• Read and apply complex procedures and regulations
• Establish and maintain effective working relationships with a variety of individuals under potentially hostile or emotional circumstances
• Assemble pre-billing packages and prepare bills
• Evaluate, determine and approve eligibility for specialized publicly-funded medical care payment programs
• Prepare medical billing for electronic billing submission.
• Evaluate patient payor sources; and follow-up on past due accounts
• Evaluate, determine and approve eligibility for specialized publicly-funded medical care payment programs.
• Operate a patient accounts computer system
• Evaluate patient financial status and payor sources, establish payment plans and follow-up and collect past due accounts
• Read and apply complex procedures and regulations

Additional Information

• Natividad requires that all incumbents pass a pre-employment physical/medical assessment.
• Natividad will conduct a thorough background and reference check process which includes a Department of Justice fingerprint check.
• Employees who drive on County business to carry out job related duties must possess a valid CA Driver License for the class vehicle driven.
• Employees must have and show their original Social Security Card and a valid CA Driver License or CA State ID prior to the first day of work.
• Incumbents may be required to work all shifts, including weekends and holidays.

• If you believe you possess a disability that would require test accommodation, please contact the HR Analyst for Natividad at (831) 783-2711.
• Employment is contingent upon acceptable documentation verifying identity and authorization for employment in the United States.
• If you are hired into this classification in a temporary position, your salary will be hourly and you will not be eligible for the benefits listed above.