Sr. Patient Finanical Services Specialist

Company: Alameda Health System
Location: San Leandro
Posted on: May 3, 2021

Job Description:

Sr. Patient Finanical Services SpecialistSan Leandro, CAFinancePatient Financial Svcs - FacilFull Time - DayReq #:29031-19556FTE:1Posted:TodayApply Now Save Job SavedSummarySUMMARY : The Sr. Patient Financial Services Specialist, is the Lead, and is responsible for assisting staff with the Self-Pay/Customer Service/ Billing and / or Follow-up of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible. This position will have working knowledge and understanding of managed care contracts including other complex payment methodologies to ensure prompt and accurate reimbursement. This position must be able to utilize and understand many complex and varying State and Federal statutes and regulations, guidelines and systems, and perform the account follow-up function with all Self-Pay/Customer Service payers and government agencies to obtain maximum and correct reimbursement of accounts receivables. This position proactively interacts with insurance companies, government agencies and/or patients to obtain maximum and correct reimbursement of accounts receivable. Supports Management with day-to-day operations and works closely with the department/unit supervisor/manager to ensure a high level of performance with a commitment to continuous improvement.RESPONSIBILITIES : The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.Acts as a working supervisor for the assigned PFS unit, provides guidance and instruction to new employees, assigns work to staff, and acts as a resource providing answers for unusual problems encountered in the work of the unit. Provides input to management on matters related to employee performance and discipline.Assumes responsibility through reviewing and posting adjustments, balancing records & batches for the maintenance of accounts within the EHR systems.Audits complex patient accounts / claims for charge and quantity errors and compliance with program billing requirements.Collects, organizes, and summarizes statistical data and maintains specialized records in connection with the various program requirements.Compiles accounting, program revenue and statistical reports for department review or incorporation into a summary report or statement required by State, Federal, or program agencies related to AHS program participation; may act as a liaison with other agency/department representatives regarding billing / claims /program initiatives.Performs special research or training projects requiring a comprehensive understanding of billing and/or collection procedures; provides input to management regarding operational needs; troubleshoots procedural problems and recommend changes or new procedures.Prepares or supervises the preparation of standard statistical statements, reports, and analysis as required.Maintains data files and records; and performs general clerical duties as required.Oversees or is personally responsible for complex billing issues, collection or statistical record keeping operation which may involve careful and detailed auditing of program claims, inventory, billing documents and hospital charge data.Performs refund and credit analysis, audit, and reimbursement functions for all patient credit balance accounts.Responsible for the review, preparation, and submission of the Credit Balances Quarterly Report.Responsible for follow up on applicable credit balance accounts.Responds to patients and Insurance phone calls regarding account balances and refunds.Handle correspondence received from payers requesting refunds.Reports on root causes of Credit Balances to management.Interacts with facilities to resolve accounts.Other duties as assigned.MINIMUM QUALIFICATIONS:Any combination of education and experience that would likely provide the required knowledge, skills, and abilities as well as possession of any required licenses or certifications is qualifying.Required Education: High School diploma.Business related courses, preferred.AA or medical certification program preferred.Required Experience: Minimum 3 years experience and understanding of Self-Pay/Customer Service / Hospital billing and collections processes, required. OR two years of billing and collections experience in Patient Financial Services at AHS.

Keywords: Alameda Health System, San Leandro , Sr. Patient Finanical Services Specialist, Other , San Leandro, California