Self-Pay Collections & Pre-Authorization Analyst – Financial Services

Powell Valley Healthcare; Powell (WY); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Long-term disability

PTO accrual (20 days/yr)

Extended Illness Bank

9 paid holidays

Tuition savings plan

PTO cash-out

Tuition reimbursement

Fun to be Fit program

Club Dauntless discount

HRA flex spending

Job summary

Powell Valley Healthcare in Powell, Wyoming is seeking a full-time Medical Collections Specialist to manage patient and insurance balances with empathy and professionalism.

In this role, you will negotiate payment plans, resolve disputes, and ensure accuracy in billing while complying with HIPAA and healthcare privacy rules. You will also document activities and collaborate with the billing team to improve revenue cycle processes.

Qualifications

• Strong bookkeeping knowledge and accuracy in financial processes.
• Proficient with common office equipment (PCs, printers, terminals, calculator, fax, copiers).
• Experience with Windows Excel and Word and healthcare systems applications.

Responsibilities

• Follow up on outstanding balances from patients and insurance providers.
• Negotiate payment arrangements and resolve billing disputes to recover revenue.
• Communicate professionally and empathetically with patients about owed amounts, explaining billing statements and payment options.
• Regulatory knowledge — understanding of healthcare billing laws and privacy regulations. Ensure compliance with 501 r-6 and HIPAA privacy rules.
• Document all collections activity accurately in billing systems. Communicate with patients about financial obligations per individual insurance plans.
• Take patient payments (check-by-phone, ACH, etc.) and verify account accuracy. Communicate with patients about financial obligations.
• Process Prior Authorization of assigned encounters along with reviewing patient coverage and patient responsible balance.
• Patient communication— clear, empathetic, and professional interactions. Review all admission paperwork to determine accuracy and verification needs.
• This position will also answer patient customer service calls to fill in when needed.
• Other duties as assigned.

Skills

Bookkeeping

Office equipment

Excel & Word

Healthcare systems

Communication

Education

High school diploma or GED

Experience in medical field preferred

Job description

At Powell Valley Healthcare, providing quality healthcare to our community is our top priority. We are located in the heart of Powell, Wyoming; just 25 miles outside of Cody. We believe in creating positive and safe environments for both our patients and our staff. Being part of our organization means becoming a cornerstone in the patient experience and their care.

Here at PVHC, we offer a wide array of benefits in a way that allows you to choose options and build a package that works best for you. Some of the benefits we offer include:

• Health, dental and vision insurance
• Life insurance
• Long term disability coverage
• PTO – New employees accrue the equivalent of up to twenty days of PTO withing their first calendar year
• EIB (Extended Illness Bank) – Our version of accrued sick leave
• Nine paid holidays which includes two personal holidays
• Tuition Savings Plan
• Opportunities to cash out PTO for personal use, student loan payments, and in-house medical bills
• Tuition reimbursement – up to $5,000 per year
• Fun to be Fit program and Club Dauntless Membership Discount
• HRA – Flex spending accounts

POSITION SUMMARY:

Current opening: One Full-time position (40 hours per week; 8:00am – 5:00pm)

Responsible for working with outside collections agencies to reconcile patient accounts and provide integrity check of patient responsibility balance in billing system. Counsel patients on insurance eligibility, coverage, patient responsibility, and Financial Assistance. Work assigned system reports and encounters. This position will also be responsible for an assigned portion of Pre-Authorizations.A patient collection professional (often called a Medical Collections Specialist or Healthcare Collections Specialist) is responsible for recovering unpaid patient and insurance balances, negotiating payment plans, and resolving billing disputes while maintaining compliance and positive patient relationships

ESSENTIAL FUNCTIONS:

• Follow up on outstanding balancesfrom patients and insurance providers
• Negotiate payment arrangementsand resolve billing disputes to recover revenue
• Communicate professionally and empathetically with patients about owed amounts, explaining billing statements and payment options
• Regulatory knowledge — understanding of healthcare billing laws and privacy regulations. Ensure compliance with 501 r-6 and HIPAA privacy rules.
• Document all collections activity accurately in billing systems Communicate with patients of all financial obligations per individual insurance plans.
• Take patient payments (check-by-phone, ACH, etc.) and verify account accuracy. Communicate with patients of all financial obligations.
• Process Prior Authorization of assigned encounters along with reviewing patient coverage and patient responsible balance.
• Patient communication— clear, empathetic, and professional interactions.Review all admission paperwork to determine accuracy and verification needs.
• This position will also answer patient customer service calls to fill in when needed.
• Other duties as assigned.

KNOWLEDGE, EDUCATION AND EXPERIENCE REQUIRED:

• High school diploma or General education degree (GED) required.
• Previous work in the medical field is preferred.

SKILLS AND ABILITIES REQUIRED:

• Strong working knowledge and skills in essential bookkeeping functions.
• Skills in operation of typical office equipment such as P. C’s, printers, terminals, calculator, FAX, Copiers.
• Knowledge and experience in using, Windows Excel and Word as well as small business application, and Health Care systems Applications.
• Must be able to communicate efficiently and professionally with patients and families.

PHYSICAL DEMANDS/REQUIREMENTS:

• Regularly lifting or move objects weighing 10 pounds.
• Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision, and depth perception.
• Reaching, handling, feeling, talking, hearing, stooping, bending, crouching, walking, standing, and working with equipment.
• Subject to inside and possibly outside weather conditions.
• The employee is also subject to exposure to blood and body fluids, proximity to moving mechanical parts, electrical shock, exposure to burns and radiant energy, exposure to explosives, exposure to toxic chemicals and biological agents.