What are the responsibilities and job description for the Patient Account Specialist position at RML HEALTH PROVIDERS?
Job Details | |
Job Title: Patient Account Specialist | Department/Location: Patient Accounts / Hinsdale, IL |
Shifts: Days/ Hybrid 2 days in office / 3 days WFH | Full-time (80 hours per pay period) benefit eligible |
FTE: 1.0 | Req. Number: 1599 |
Benefits
RML offers competitive compensation and excellent benefits package. Employees can choose from a large selection of benefits that help protect their health, wealth, and well-being. Benefits include:
Medical Dental Vision Flexible Spending Accounts Health Savings Account | 401(k) Retirement Plan (6% company match) - For every $1 an employee contributes, RML contributes $1 to their accounts. Employees are 100 percent vested in the money both they and RML contribute. | Tuition Reimbursement up to $5k per calendar year | Employee Assistance Plan (EAP) For employees who may need help managing stress, RML offers an EAP at no cost. Counselors are available 24 hours a day to both employees and their family members. | Disability Insurance
|
Life and Accidental Death Insurance | Free Parking | Banking Alternatives (e.g. HealthCare Associates Credit Union)
| Referral Rewards (upwards of $4k) | Employee Fitness Room |
GENERAL SUMMARY:
Under the supervision of the Supervisor of Patient Financial Services, assumes responsibility for the coordination and direction of the Patient Accounts billing and collection activities for hospital and physicians. Assists in the design and implementation of improved billing systems to facilitate more efficient patient billing, reduce write-offs and improve hospital cash flow; prepares financial, statistical, and productivity reports which summarize Patient Accounts receivable activity, identifies and analyzes payment variances; completes other billing and collection projects as assigned.
PRINCIPAL DUTIES & RESPONSIBILITIES:
- Supports the Mission and Vision of RML Specialty Hospital by demonstrating RML’s Core Values of Service, Teamwork, Accountability, Integrity, Respect and Stewardship (STAIRS) in all actions. Promotes a positive patient/customer experience by exemplifying the principles of the Language of Caring in all interactions with patients, families and coworkers.
- Performs routine and complex billing, reimbursement, and A/R management functions in association with Medicare, Medicaid and Third Party Payers for both UB04’s and 1500’s. This includes ensuring that all secondary payer claims and Medicare exhaust claims are processed in accordance with departmental policy to achieve maximum payment for RML.
- Verifies insurance coverage and follow-up with payers to ensure coverage for services provided.
- Ensures accurate contractual adjustments for all payers. Reports any contract payment discrepancies to management on a timely basis.
- Ensures accurate and timely submissions of claims; proactively analyzes account activity, identifies problems and initiates actions.
- Negotiates, recommends, and communicates payment expectations or any other reimbursement issue within hospital policies and procedures.
- Collects and assesses payments and identifies when reimbursement is not in compliance with specific RML contracts.
- Identifies and works to minimize potential financial risk of patient accounts through financial reports, systems information, or direct contact.
- Identifies and resolves third party and patient credit balances; this includes monitoring the causes of credit balances and reporting back to management.
- Challenges and appeals third party denials and rejections; follows through with appropriate resolution, including initiating corrective action.
- Educates and assists patients and customers in understanding PFS processes and hospital policies, procedures and expectations.
- Responds timely to customer service; patient bills, complaints and billing disputes.
- Ensures compliance with Federal and State regulations.
- Performs backup for the Admitting Dept. when necessary and timely reviews all financial verifications performed by the Manager of Admitting.
- Assists management with projects.
- Performs other duties as assigned.
JOB REQUIREMENTS & CHARACTERISTICS
MINIMUM | PREFERRED | |
Skills & Abilities | Ability to work independently under pressure situations. Uses sound judgment in making decisions. Interpersonal skills to communicate with patients, insurance carriers and peers. Mathematical skills needed to calculate and apply credit/debits to accounts. | |
Knowledge & Experience | Working knowledge of personal computers specific to spreadsheet and word processing software. 3-5 years of billing/collection experience within a hospital inclusive of hospital & physician billing and collections responsibility. Medicare, Medicaid and Third party experience. Worked with UB04 and HCFA 1500 forms. Knowledge of Nebo/NDAS, Ecare, Microsoft Office, and hospital and physician billing applications. | 7 – 10 years hospital and physician billing/collection experience. Experience with Meditech, eCare Claims Management, Inpatient hospital billing, admitting applications and Medisoft physician billing application. Experience working in an LTCH setting. |
License & Certifications | ||
Working Conditions | Work is performed in a normal office environment |
The above statements are intended to describe the general nature and level of the work being performed by people assigned to this job. They are not exhaustive lists of all duties, responsibilities, knowledge, skills, abilities, and working conditions associated with it.
1/2024
Salary : $5,000
