JOB SUMMARY ##### Responds to all patient inquiries by performing an assessment of both hospital and professional accounts and initiates appropriate action to ensure customer satisfaction. #ESSENTIAL DUTIES AND RESPONSIBILITIES## Researches and performs audits on patient accounts to determine where balances are due, from third party payers or patient responsibility. In-depth understanding of collection laws.# Understands statement cycles, the bad debt process and how to balance files after the transfer process is complete.
Has in depth knowledge of community based, state or federal government programs to provide assistance to patients who have no ability to pay for their health care needs.# Screens patients and provides assistance with completion of the application process. Thorough understanding of how to identify if charges on a patient#s account are correct.# In depth understanding of what information is available to assist# in the process, such as the medical record, Chartview, MPI, etc. Familiar with managed care contract reimbursement rates.# Understands terminology associated with contracts as well as familiar with the terminology and calculations used on a payment voucher and patient#s explanation of benefits.
Understands Medicare reimbursement of DRGs, APCs or physician fee schedules. Responds to patient inquiries via in person, mail, phone and/or email.# Sends #stat# requests to appropriate partner and works with partner as needed to resolve patient issue/question. Responds to third party and patient requests on credit balances and initiates the refund process in the event monies are due back to the payer or patient.
Documents all patient encounters on appropriate patient account/claim utilizing notes.# Ensures account is updated to accurately reflect the current status. Serves as a liaison to all patient financial staff by maintaining good communication regarding any problems and/or resolutions to patient issues. Handles complaints and grievances, ACD monitoring and creates reports for follow-up on an ad hoc basis.
Performs other duties as assigned #EDUCATION # EXPERIENCE## High school diploma or equivalent required. #2 - 3 years customer service experience preferred or 1 year customer service in medical field preferred ADDITIONAL REQUIREMENTS Passing the Driver#s License Check and/or Credit Check (for those positions requiring). Passing the WI Caregiver Background Check and/or IL Health Care Workers Background Check. Must be able to follow written/oral instructions.
The purpose of this position is to answer all incoming calls into the call center for our patients.
Mercy Health System