Patient Accts Rep Amb_IBT

RIH Rhode Island Hospital; Rhode Island; On-site; USD 32,000 - 52,000; Full time

Job summary

Brown University Health seeks a detail-oriented clerk to support patient registration, billing and welfare eligibility at Rhode Island Hospital in Providence. You will collect demographics, verify insurance, discuss balances, and determine eligibility for free services while guiding patients through payment options.

You will document insurance information in PMAS, obtain authorizations, and register patients for clinics and procedures in ambulatory settings, supporting billing and revenue cycles

Qualifications

• A level of knowledge generally obtained through completion of High School with additional math and computer courses.
• Well developed interpersonal and communication skills in order to obtain patient information and deal effectively with the public at point of contact.
• Persuasive collection techniques. Ability to tactfully set payment arrangement terms and collect money.
• Full knowledge of third party health insurance claims processing, coverage and documentation requirements.
• Math skills and the ability to operate on-line computer terminal.
• Acquired knowledge of Accounting Department patient billing systems.

Responsibilities

• Competes Hill-Burton application when patient lacks evidence of adequate health insurance coverage, according to established criteria for provision of uncompensated hospital services.
• Requires patient to sign statement of financial responsibility.
• Assists patient to apply for welfare coverage, if no coverage is obtained or if can not pay.
• Determines eligibility for Rhode Island Hospital free service for clinic visit only, using sliding scale and based on established guidelines for same.
• Advises Senior Patient Advocate of patients lacking health insurance coverage and/or sources of income sufficient to reimburse Hospital for services rendered.
• Completes documentation required to initiate commercial insurance, Workers’ Compensation and/or CHAMPUS claims.
• Verifies third-party insurance plan numbers and benefit level.
• Documents all information obtained in PMAS accounting notes.
• Contacts insurance carrier when necessary to obtain treatment authorization and co-payment information.
• Obtains authorization for treatment from health maintenance organizations, verifying coverage as needed.
• Discusses existing Hospital account balances and arranges payment schedule for same.
• Requests evidence of coverage or requested payment ranging from partial to full cost for clinic visit or entire treatment series.
• Requires completion of Financial information to make payment arrangements when patient unable to pay entire amount.
• Upon determination that a liability claim exists, completes lien form and notes in PMAS accounting file.
• Collects cash/credit card payment for Outpatient/Emergency/Trauma services when possible.
• Posts payments to specific general ledger account.
• Prepares bank deposit for pickup by cashier twice daily.
• Determines priority of health insurance coverage.
• Registers all patients on-line by entering appropriate data to computer system via terminal.
• Embosses identification card in order to initiate or update patient Hospital record.
• In ambulatory registration, registers all patients for PAC Operating Room, clinics and ancillary areas.
• Takes APC Operating Room bookings and initiates all charge vouchers for out-patient procedures in Emergency Department registration, notifies appropriate security agency of emergency treatments resulting from assaults, gunshot wounds, animal bites, accidents and the like, according to Rhode Island State Department of Health regulations.
• Follows up on third-party documentation from Private Physician’ offices and other hospital off-hour ancillary areas.

Skills

Interpersonal skills

Communication skills

Persuasive collections

Math skills

Online data entry

Education

High School diploma

Tools

PMAS accounting

Billing software

Job description

SUMMARY

General supervision but according to established credit policies and procedures, interviews and registers patients for Emergency/Trauma Center or Ambulatory treatment by obtaining demographic, third-party insurance and related financial information, entering same to on-line computer system. Completes third-party documentation, discusses any existing balances for previous Hospital services rendered and makes preliminary determination on welfare eligibility. Request cash deposit approximating charge for scheduled services or co-insurance if applicable, and/or the co-payment required by third party coverage for clinic visits and outpatient ancillary service. Arranges payment terms. Contacts Patients Accounts Advocate, when applicable. Determines eligibility for free service when necessary. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate

RESPONSIBILITIES

Competes Hill-Burton application when patient lacks evidence of adequate health insurance coverage, according to established criteria for provision of uncompensated hospital services. Requires patient to sign statement of financial responsibility. Assists patient to apply for welfare coverage, if no coverage is obtained or if can not pay. Determines eligibility for Rhode Island Hospital free service for clinic visit only, using sliding scale and based on established guidelines for same.Advises Senior Patient Advocate of patients lacking health insurance coverage and/or sources of income sufficient to reimburse Hospital for services rendered.Completes documentation required to initiate commercial insurance, Workers’ Compensation and/or CHAMPUS claims.Verifies third-party insurance plan numbers and benefit level. Documents all information obtained in PMAS accounting notes. Contacts insurance carrier when necessary to obtain tr5eatment authorization and co-payment information.Obtains authorization for treatment from health maintenance organizations, verifying coverage as needed.Discusses existing Hospital account balances and arranges payment schedule for same. Requests evidence of coverage or requested payment ranging from partial to full cost for clinic visit or entire treatment series. Requires completion of Financial information to make payment arrangements when patient unable to pay entire amount. Upon determination that a liability claim exists, completes lien form and notes in PMAS accounting file.Collects cash/credit card payment for Outpatient/Emergency/Trauma services when possible.Posts payments to specific general ledger account.Prepares bank deposit for pickup by cashier twice daily.Determines priority of health insurance coverage.Registers all patients on-line by entering appropriate data to computer system via terminal. Embosses identification card in order to initiate or update patient Hospital record. In ambulatory registration, registers all patients for PAC Operating Room, clinics and ancillary areas. Takes APC Operating Room bookings and initiates all charge vouchers for out-patient procedures in Emergency Department registration, notifies appropriate security agency of emergency treatments resulting from assaults, gunshot wounds, animal bites, accidents and the like, according to Rhode Island State Department of Health regulations.Follows up on third-party documentation from Private Physician’ offices and other hospital off-hour ancillary areas.

MINIMUM QUALIFICATIONS

• BASIC KNOWLEDGE: A level of knowledge generally obtained through completion of High School with additional math and computer courses.
• Well developed interpersonal and communication skills in order to obtain patient information and deal effectively with the public at point of contact.
• Persuasive collection techniques. Ability to tactfully set payment arrangement terms and collect money.Full knowledge of third party health insurance claims processing, coverage and documentation requirements.
• Math skills and the ability to operate on-line computer terminal.Acquired knowledge of Accounting Department patient billing systems.

EXPERIENCE

Experienceix to twelve months of previous clerical support experience is required, preferably in a setting that demonstrates ability to function effectively in high-volume clinics.Previous experience with on-line data entryccess system required.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS

Working conditions are generally good, little discomfort due to noise, heat, and dust.

SUPERVISORY RESPONSIBILITY

None.

Pay Range

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

LOCATION

Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903

Work Type

Monday Wednesday Thursday Friday 630am-5pm

Work Shift

Day Driving Required: No Union: International Brotherhood Teamsters

ABOUT BROWN UNIVERSITY HEALTH

As Rhode Island's largest health system and private employer, Brown University Health is the state's premier provider of health services and includes the only Level I Trauma Center for southeastern New England. Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day. Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of The Warren Alpert Medical School of Brown University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi-specialty practice in Rhode Island. Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve. We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well-being of our employees and their families. Join us and help build a healthier future for our patients - and for yourself. Company Location Belonging and Engagement Nursing Our Mission