DHR Health - US:TX:Edinburg - Days
Summary:
FLSA STATUS: Exempt Non-Exempt
MISSION STATEMENT:
Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.
VISION:
Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.
POSITION SUMMARY:
This position is responsible for business office activities which include collection of accounts receivable, cashiering, correspondence, cash balancing and provides refunds for services to patients and third party payors as needed.
POSITION EDUCATION/ QUALIFICATIONS:
- High School Diploma/GED Required
- Comprehensive knowledge of healthcare reimbursement.
- Understands medical terminology.
- Familiarity with EOB’s and RA’s.
- Knowledge of Microsoft Office suite, working knowledge of Excel required.
- Must be able to multi-task.
- Good written and verbal communication skills required.
- Ability to read, write and speak English
- Ability to communicate clearly and concisely with all levels of management
- Previous healthcare experience (2-3 yrs.) required, hospital experience preferred.
JOB KNOWLEDGE/EXPERIENCE:
- Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties
Establishes and maintains long-term customer relationships, building rapport with other department staff
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Demonstrates proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required.
Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.
Medical Terminology, ICD-9 Codes, ICD-10, CPT Codes, HCPCS code knowledge required.
Ability to use the internet to obtain information from Third Party Payers or other sources is required.
Responsibilities:
POSITION RESPONSIBILITES:
- Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
- Receives incoming and outgoing calls from patients and informs them of their balance due after insurance has paid.
- Assists patients and carriers with questions and concerns regarding the billing and collections of accounts.
- Works special projects as assigned.
- Assist with posting payments.
- Review of Patient Balance for Statement Release.
- Distribute office mail.
- Review total charges, amount of insurance benefits paid and balance owed by patient or responsible party.
- Explains hospital payment policies and collects patient balance due and writes receipts for all payments collected.
- Performs daily reconciliation of petty cash.
- Download and post electronic remits from payer websites or relay.
- Apply payments and adjustments as per remittance advice.
- Balance daily payments with accounting.
- Report payments and ERA files to Renaissance Lab.
- Download, run and post credit card payments.
- Researches credit balances for accurate processing of refunds due to over payments and/or allowances requiring a correction in a timely manner.
- Keep track and report unclaimed property.
- Run incorrect I-plan report.
- Completes and submits payer applications.
- Prepares credit worksheet and processes all transactions required to request refund checks or to correct account balances.
- Transfers patient credit balances to outstanding accounts according to hospital policy and procedure, and prepares letters of explanation concerning refund issued to third party payers and patients.
- Researches credit balances for accurate processing of refunds due to over payments and/or allowances requiring a correction in a timely manner.
- Requests the transfers of patient credit balances to outstanding accounts according to hospital policy and procedure, and prepares letters of explanation concerning refund issued to third party payers and patients.
- Researches and prepares quarterly Medicare credit report.
- Responds to all mail and phone calls concerning credit balances and refunds checks.
- Responds to correspondence from insurance carriers in a timely manner.
- Scan correspondence into Cerner.
- Refers accounts that need insurance billing or rebilling to appropriate biller.
- Post inbox adjustments for business office area.
- Run pathology report daily.
- Run zero balance and recoupment report.
- Report Medicaid managed totals to accounting daily.
- Ensure all batches are closed by the end of the day.
- Is proficient in accessing information needed from Cerner and AX document imaging software.
- Ability to access medical records from Cerner system to appeal claims with carriers.
- Select correct adjustment codes for accounts that need adjustments and document reason.
Other duties as assigned.
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LINES OF REPSONSIBILITES:
(Chain-of-command)
1. Manager 2. Director
Other information:
CUSTOMER SERVICE:
Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.
AGE SPECIFIC:
Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.
AMERICANS WITH DISABILITIES ACT: (ADA):
A. Essential Duties: Indicated by bold print within performance standards, preceding individual numbered criteria.
The following table provides physical requirements that will be associated with, but not limited to, this position:
Light/moderate lifting up to 20 lbs, from the floor to shoulder height.
Must be able to assist other employees with lifting more than 20 lbs.
Light/moderate carrying up to 20 lbs.
Dual simultaneous grasping
Operating office equipment
Operating mechanical equipment
Ability to read and write
Ability to hear verbal communication without aid
Operating Personal Vehicle
Ability to comprehend written/verbal communication
Other: Ability to deal with stress
B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.
C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.
D. Aptitudes: HIGH 1 2 3 4 5 6 LOW
Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles. Ability to reason and make judgments. 3
Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3
Numerical: Ability to perform arithmetic operations quickly and accurately. 2
Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2
Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3
Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2
Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3
Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3
Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3
Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3
Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3
I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.