Patient Billing & Revenue Specialist

Kaweah Delta Health Care District; Visalia (CA); Vor Ort; USD 45.000 - 65.000; Vollzeit

Zusammenfassung

Kaweah Health in Visalia, CA is seeking a Patient Accounting professional to manage payer compliance, billing accuracy, and accounts receivable within the Patient Financial Services department.

The role requires prior patient accounting/admissions experience and a high school diploma. The position is full-time and includes standard benefits, with day shift responsibilities in the United States healthcare setting.

Qualifikationen

• Prior Patient Accounting or admissions experience.
• High school diploma or equivalent preferred.
• Comparable medical billing education may be considered.

Aufgaben

• Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring the Kaweah Health is being reimbursed by the payer in accordance with governmental or contract terms.
• Brings any reimbursement or compliance concerns to the attention of the Patient Accounting Manager.
• Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company and plan, and charges. 100% accuracy of this information is required to ensure proper recording of revenue, necessary authorizations are obtained, payer classification, correct billing of patient account, and other statistical indicators. Brings any unresolved issues to the attention of their manager.
• Audits unbilled reports for potential holdups of patient accounts. Works closely with Medical Records on coding issues, Insurance Verification Clerk on insurance issues and other departments as necessary.
• Completes billing process. Ensures all charges are accurate and appropriate. Payer guidelines will be followed during the billing process. After billing has been completed, uses appropriate charge description master (CDM) number to identify the payer and when the account was billed. Works closely with departments on unresolved issues.
• Reviews and researches patient account credits and refunds as appropriate to patient and/or payer. For governmental payers, has the credit retracted.
• Receives all correspondence and inquiries related to patient accounts and payer contract for which they are responsible. Answers mail and take appropriate action within specified timeframe.
• Bills any secondary payers, change financial classes accordingly and sends appropriate collection system letter to patient for co-pays and deductibles owed, denied services, amounts applied to deductible, etc. Uses correct CDM code to identify what secondary payer was billed and when.
• Reviews and works aging reports to identify unpaid patient accounts. Follows up with payers for timely reimbursement.
• Works to ensure that days in accounts receivable goals are met maintained and/or lowered. Maintains job productivity and quality standards on a consistent basis as established by division management.
• Answers phones as a back up to other departmental staff. Takes messages or routes calls as appropriate. As back up, assists customers at the service counter.
• Conforms with patient confidentiality standards.
• Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
• Performs other duties as assigned.

Kenntnisse

Patient accounting

Ausbildung

High school diploma or equivalent

Jobbeschreibung

Kaweah Health in Visalia, CA is seeking a Patient Accounting professional to manage payer compliance, billing accuracy, and accounts receivable within the Patient Financial Services department.

The role requires prior patient accounting/admissions experience and a high school diploma. The position is full-time and includes standard benefits, with day shift responsibilities in the United States healthcare setting.