Private Pay Billing Specialist

JOB SUMMARY

Under the general supervision of the Manager of Patient Financial Services, this position is responsible for performing various daily billing functions as needed.  Process accounts of uninsured patients for hospital services.  Perform insurance verification on each account looking for Medicare, Medicaid or other insurance coverage.  Perform self-pay job functions.  Strives for superior performance by consistently providing a product or service to leadership and staff that is recognized as ultimately contributing to the patient and family experience.  Recognizes and demonstrates understanding of patient and family centered care.

PRIMARY JOB RESPONSIBILITIES

1. Process self-pay bills daily and perform eligibility verification for possible Medicaid, Medicare, and Blue Cross coverage.  Utilize Meditech to check for possible insurance coverage by researching previous accounts.
2. Refer, when applicable, inpatient and outpatient accounts to Advomas or other agencies contracted to assist in Memorial Healthcare in obtaining Medicaid, Medicare, or other coverage for payment of accounts.
3. Work on weekly and monthly reports from above mentioned agencies to ensure timely billing of accounts for which insurance coverage is obtained, to maintain an accurate inventory of accounts being worked by above agencies, and to move accounts through the billing phase if insurance coverage is unable to be obtained.
4. Process financial assistance applications.
5. Process weekly files sent to and from outside vendors that assist with self-pay accounts.
6. Assist with the monthly collections process.
7. May process client bills at the beginning of each month. Work with client representatives to resolve issues and obtain timely payments.  Post cash receipts to client accounts.
8. Work with weekly private pay credits list and transfer credits to other open accounts or refund patients if needed.
9. Assist, when necessary, with insurance refunds.
10. Demonstrates knowledge of and supports hospital mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, customer service standards, and the code of ethical behavior.
11. Self-pay payment processing
12. Answer patient calls.
13. Distribute mail

DEPARTMENTAL AND ADDITIONAL JOB RESPONSIBILITIES

1. Maintain strict confidentiality related to all Memorial Healthcare data and information as dictated by hospital standards, policies, and procedures. 
2. Access Memorial Healthcare systems and work information only as necessary to perform job duties.
3. Other duties as requested or assigned by the Director of Patient Financial Services.

JOB SPECIFICATIONS

EDUCATION

1. High school diploma or equivalent is required. 

EXPERIENCE

1. Experience with Word and Excel is preferred. 
2. Customer service experience is required.

ESSENTIAL PHYSICAL ABILITIES/MOTOR SKILLS

These physical requirements are not exhaustive and additional job-related physical requirements may be added on an as needed basis. Corrective devices may be used to meet physical requirements.

1. Sedentary Work: Frequently required to stand, kneel and crouch. On a daily basis may be required to move about, sit, climb stairs and bend. Is frequently required to lift and carry up to 20 lbs. May be required to push/pull/carry items between 20-100 lbs.
2. Vision: Requires the ability to perceive the nature of objects by the eye. Near acuity: Clarity of vision at 20 inches or less. Midrange Acuity: Clarity of vision at distances of more than 20 inches and less than 20 feet.
3. Motor Coordination: While performing the duties of the job, it is required to regularly perform functions that include using hand and finger movement, handle or feel objects, be able to use tools or equipment that requires reaching with hands and arms. Must be able to travel independently throughout the hospital; access patients/families including areas confined by space and/or equipment.
4. Speaking/Hearing: Ability to give and receive information through speaking and listening.

ESSENTIAL TECHNICAL ABILITIES

1. Proficiency using modern office, computer and telephone equipment as used by Memorial Healthcare.

ESSENTIAL MENTAL ABILITIES

1. Ability to adapt and maintain focus in fast paced, quickly changing or stressful situations.
2. Ability to read and interpret a variety of documents including, but not limited to policies, operating instructions, white papers, regulations, rules and laws.

ESSENTIAL SENSORY REQUIREMENTS

1. Able to see for the purpose of reading information received in formats including, but not limited to paper, computer, reports, bulletins, updates, manuals.
2. Able to see and hear for work-related purpose.

INTERPERSONAL SKILLS

1. Ability to interact with co-workers, hospital staff, administration, patients, physicians, the public and all internal and external customers in a professional and effective, courteous and tactful manner, at all times, physically, verbally and in all written and electronic communication.
2. Attention to detail and accurate documentation of billing.
3. Required to remain calm when adversity is encountered.
4. Open, honest, and tactful communication skills.
5. Ability to work as a team member in all activities.
6. Positive, cooperative and motivated attitude.