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Patient Financial Specialist - Philhaven/Mt. Gretna - PRN/As needed - Days (46743)

General Summary:
Works under direct supervision. Represents the System in a professional manner, using good customer service practices in the performance of the following duties: Is responsible for the electronic or manual billing and maintenance of patient accounts. Performs a variety of functions including, but not limited to, account follow-up, answering inquiries, resolving problems and interacting with third party payers and patients to achieve payment of accounts in accordance with current government and payer regulations.
Duties and Responsibilities:
The following are essential job accountabilities:
1 Ensures accurate financial and biographical information has been obtained and properly entered into the appropriate records.
2 Performs various functions to complete and expedite the billing process including, but not limited to, recording patient identification data and physician diagnosis, investigating charges, correcting and updating data, preparing the claim to bill, and updating computer functions.
3 Bills to third party payers via electronic or manual processes.
4 Reviews accounts and coordinates with appropriate departments on accounts requiring precertification, preauthorization, referral forms and other requirements related to managed care.
5 Reviews accounts and maintains contact with third parties to ensure timely payments. Makes written and/or verbal inquiries to third party payers to reconcile patient accounts. Follows up accounts until zero balance or turned over for collection.
6 Reviews third party payer payments and investigates accounts not paid as expected. Takes appropriate corrective action to include follow up, rebilling, and/or adjustment of contractual allowances.
7 Answers all inquiries regarding patient accounts.
8 Interprets and explains to patients and their families charges, services, and hospital policy regarding payment of bills.
9 Resolves billing problems and/or receives insurance updates.
10 Processes and distributes copies of billings as required.
11 Researches credit balance accounts. Refunds overpayments to patient, guarantor or third party payer.
12 Receives and processes incoming charges. Enters data into mainframes, PC's and/or microcomputers. Reconciles daily cash and verifies account balances. Reconciles electronic payments and computer generated reports.
Required Skills
Minimum Education - High School or G.E.D.
Minimum Experience - 3 - 6 months


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