Patient Financial Services Collection Specialist
Company: Alameda Health System
Location: San Leandro
Posted on: June 12, 2021
SUMMARY: The PFS Collection Specialist is responsible for all
aspects reviewing payer contracts, claims and performing third
party collection activity for Professional Fee services.
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
- Responsible for all aspects of Professional Fee follow up and
collections on insurance balances, including making telephone
calls, accessing payer websites. Identify issues or trending and
provide suggestions for resolution. Accurately and thoroughly
documents the pertinent collection activity performed. Review the
account information and necessary system applications to determine
the next appropriate work activity.
- Verify claims adjudication utilizing appropriate resources and
applications. Initiate telephone or letter contact to patients to
obtain additional information as needed. Perform appropriate
follow-up functions, including manual re-submissions as well as
electronic attachments to payers. Manage and maintain desk
inventory, complete reports, and resolve high priority and aged
- Respond timely to emails and telephone messages as appropriate.
Communicate issues to management, including payer, system, or
escalated account issues.
- Maintains information or operational records; screens reports
for completeness and mathematical accuracy; list, abstracts, or
summarizes data; compiles routine report from a variety of
- May, as a secondary responsibility, interpret abstracts,
orders, notes, invoices, permits, licenses, etc.; computes and
receives fees when the amount is not in question or is readily
obtainable from fixed schedules; posts data; and prepares reports
in accordance with pre-determined forms and procedures.
- Prepare documents for collection of revenues from third party
payer programs; checks and verifies charge rates for services;
reconciles account balances and verifies payments.
- Reviews billing documents to assure program compliance for
Medicare, Medi-Cal, Managed Care, Mental Health, and insurance
payer programs; assures that all appropriate medical documentation
is included in the billing package. Assures that all appropriate
medical documentation is submitted timely.
- Interacts with all campuses to resolve accounts.
- Other duties as assigned.
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
Required Education: High school diploma or equivalent
Minimum Experience: One year of experience in a Revenue Cycle
area within the Alameda Health System; OR the equivalent of two
years' experience, performing medical billing/collections or
medical accounts receivable functions in a healthcare insurance
Keywords: Alameda Health System, San Leandro , Patient Financial Services Collection Specialist, Other , San Leandro, California
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