Patient Account Specialist
Job Code: 28890
Position Summary
Responsible for billing and collecting patient cost share balances from third party claims and billing and collecting self-pay claims. Generates and mails patient statements and final notices, initiates collection calls and responds to incoming calls from patients and guarantors making payments or inquiring about billing status. Researches and resolves complex billing issues, utilizing knowledge of current hospital and medical billing and reimbursement methodologies. Works in close coordination with Financial Counselors and Customer Service personnel to support a favorable patient experience.
Responsibilities
• Performs Accounts Receivable Collections by issuing patient statements, making outbound collections calls and handling inbound patient calls to take payments or respond to billing inquiries
• Reviews patient account to ensure account balance accuracy before statement is generated
• Works with Business Services, Financial Counseling, Coding, HIM, Patient Advocacy, and clinical departments to resolve patient inquiries, or billing or patient care complaints
• Researches and resolves claims discrepancies or routes claims issue to appropriate department for resolution
• Processes and posts patient payments to guarantor accounts. Assures that payments not specifically directed by the patient or guarantor are applied per established payment posting logic (programming)
• Analyzes patient accounts receivable to respond to patient billing concerns; escalates to Patient Advocacy when patient questions are related to a patient care complaint
• Identifies billing and coding errors from the EOB posting and works with source departments to facilitate corrections as needed
• Identifies Commercial, Medicare, Medicaid and other coverage, in coordination with the patient; assigns the correct primary and secondary payer information and transfers account to Business Services for processing of corrected claim. Enters notes in the billing system to document corrected billing actions
• As needed for newly identified third party payer coverage, verifies insurance eligibility and benefit information, collects patient co-payments, co-insurances, and deductibles
• Supports Financial Counseling by completing financial assistance screening for patients who express an inability to pay, per Financial Assistance policy. Transfers patient to Financial Counseling Department, as appropriate
• Performs other related duties as assigned
• Familiar with standard concepts, practices, and procedures within the field
• Relies on experience and judgment to plan and accomplish goals
• Regular and predictable attendance is an essential job function
• Competent to meet age specific needs of the unit assigned
Requirements and Minimum Qualifications
• Associate’s degree in a related field preferred
• 1 year customer service and previous collections experience preferred
• 1 year experience working in a hospital/health care business office or financial clearance department, scheduling, or registration preferred
• Working knowledge of current health insurance reimbursement methodology, hospital and medical billing practices preferred
• Ability to read and explain an Explanation of Benefits (EOB) and Remittance Advice (RA) preferred
• Familiarity with CPT codes, and medical terminology, preferred
• Excellent communication, organizational and analytical skills required
• Knowledge and demonstrated competence working with Microsoft Office software
Working Conditions
• Must be able to lift and move up to 10 lbs
• Must be able to reach arms above or below shoulder height
• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements
About Kootenai Health
Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.
As your next employer, we are excited to offer you:
100% employer-paid health insurance premiums for full-time employees. Part-time employees pay only a small portion a month for medical, dental, and vision coverage. Benefits start 1st of the month following 30 days of employment
Kootenai Health’s tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it
Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent.
Competitive salaries with night, weekend, and PRN shift differentials
An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching
Employees receive discounts at The Wellness Bar, PEAK Fitness, various cell phone carriers, and more
Robust and interactive employee referral program
And much more
Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you!
Apply today! Please reach out to Lindsay Buchanan lbuchanan@kh.org. You can also contact the HR Front Desk at 208-625-4620 or email careers@kh.org with any questions.
Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.