Position Details
Position Summary
This position is responsible for daily activities associated with escalated patient billing disputes and concerns. Coordinates with internal departments, guarantors, vendors, bad debt agencies and payors for both provider and facility charges. This includes monitoring potential system issues, trends in collections and billing processes, facilitating knowledge building with front end staff and assisting them with questions associated with patient billing. Identifies billing errors, trends and facilitates correct billing to patients. Communication is by phone (answering inbound lines and returning calls), email, mail, fax and referral from internal departments and vendors
PCH Values
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
Position Duties
- Participates in relationship management activities with guarantors, vendors and internal departments. Ability to communicate clearly to identify issues and concerns - using active listening to understand the root cause. Investigates, through coordination with other areas involved in the scheduling of services, providing the services, coding, processing the claim and final billing. Makes recommendations for any adjustments to outstanding bills and upon approval submits for processing. Communicates findings to internal areas and/or to the guarantor directly - communication is on incoming/outgoing phone lines, email, fax, mail and occasionally in person.
- Promptly acts on escalated issues identifies, investigates and coordinates any billing corrections. Communicates with early out vendor, bad debt vendor, legal representatives, risk management and guarantor as appropriate. Identifies process and service issues and communicates with Management to support process improvements.
- Monitors billing transactions to help ensure the integrity and accuracy of the revenue cycle. Reconciles patient accounts ensuring accuracy and ease of understanding for guarantor or authorized third party. Communicates with and educates responsible party on nature of billing and options for payment, including types of payment, payment plan, financial assistance processing and prompt pay options. (Processes financial assistance applications, prompt pay discounts, payment plan agreements, bankruptcy notifications, insurance updates, requests for itemized bills, etc.) Completes reconciliation of accounts assigned to vendors.
- Meets or exceeds timeliness and accuracy expectations on a daily basis.
- Participates in a variety of unit and hospital educational programs to maintain current skill and competency levels.
- Performs miscellaneous job related duties as requested.