Addresses all incoming inquiries from any customer; patient, insurance company, Hoag employee,
whether by telephone, mail or in person. Documents all activity in the facilitys legacy, Patient
Accounting System. Is familiar with Medi-Cal and other government programs, in order to refer
patients for financial assistance. Is familiar with the facilitys charity and payment plan options, in
order to assist the patient without third party coverage. Contact patients regarding self-pay balances on the
accounts receivable to evaluate the patients ability to pay and collect monies due to the hospital. Able to
work with minimal supervision.
Assists patient with billing, services, and insurance questions on the phone, via email or in person.
Contacts patients/guarantors to secure payment for services provided.
Documents all calls and actions taken in the appropriate systems. Sets the next work date if follow-up is
appropriate changes and submits/re-submits claims as indicated.
other available governmental or private programs.
completion when appropriate.
This may include installment plans and patient settlements, in accordance with Hoag policies.
Patient complaints/disputes are documented and forwarded to the appropriate person for follow up.
Responsible for following all collection policies and procedures.
Meets quality assurance and productivity standards.
Returns all voice mail messages/emails the same day received.
Generates itemized bills as needed to any customer, internal or external.
Refers all mail and phone calls of outsourced accounts to the vendor liaison.
Works patient correspondence in accordance to department policies.
Takes part in all training about third party requirements. Participates actively in any training
opportunities to enhance knowledge to help Hoag patients.
Education, Training, and Experience
High School graduate or equivalent.
Two years of experience in a hospital business office with a high call volume setting.
Understanding of hospital reimbursement methodologies, including DRGs, APCs, and standard
Knowledge of ICD-9, CPT-4 and HCPCs coding systems.
Understanding of contract payer policies and procedures.
Ability to interpret Managed Care Contracts.
Skills or Other Qualifications
Expert knowledge of self-pay collection techniques.
Working knowledge of Medicare, Medicaid, and all other third party payment methods.
Effective written and verbal communication skills.
Excellent customer service skills and telephone etiquette.
Problem-solving skills essential.
Insurance knowledge and communication with payers.
Ability to think independently and use good judgment for situations which require initiative and
Knowledge of basic office equipment.
Ability to establish work priorities and prioritize needs to meet required timelines.
Analytical and problem-solving skills.
10 Key by touch and the ability to type 45 wpm.
Basic math calculation skills.
Hoag Memorial Hospital Presbyterian