PATIENT REP III-CUSTOMER SERV - Methodist Hospitals

Overview:Responsible for responding to the customers, third party payors, and/or physician correspondence, and/or telephone calls.Responsibilities:PRINCIPAL DUTIES AND RESPONSIBILITIES(*Essential Functions)

1. Ensures that appropriate Meditech/EPIC letters series are sent out.
2. Identifies appropriate hospital accounts to ensure accurate application of payments.
3. Processes Visa, Mastercard, and Discover payments upon receipt on a daily basis and researches and prepares refund requests according to CBO policies and procedures.
4. Phones patients to obtain insurance and COB information and inform them of financial responsibility and discusses various payment options.
5. Prepare appropriate billing documents based upon current payor/hospital guidelines for all third party payors.
6. Prepares and processes any necessary adjustment/coding changes on accounts through the system based upon follow-up to expedite the collection process and to ensure the accuracy of the account daily.
7. Process all returned patient statements, determine and correct/change mailing address on all returned mail, update EPIC systems.
8. Responds to all incoming correspondence, insurance and/or patient requests within established guidelines (i.e. requests itemized, attorney requests, intermediary requests/memos, and physician requests) with two (2) working days.

Qualifications:JOB SPECIFICATIONS(Minimum Requirements)

KNOWLEDGE, SKILLS, AND ABILITIES

• Productivity requirement of 8.67 worked accounts per hour must be met.
• Reviews Guarantor with Insurance report to determine if patient has unlisted insurance.
• Updates billing indicator when collection agency changes.
• Tracks and trends types of phone calls in Symposium.
• Accurately and completely notates all telephone conversations on patient accounts.
• Determines self pay accounts qualifying for Financial Assistance as per policy.

EDUCATION

• High School Diploma/GED Equivalent Required
• Associates Business Administration Preferred
• 6 Healthcare/Medical - Business Office Required

STANDARDS OF BEHAVIOR
Meets the Standards of Behavior as outlined in Personnel Policy and Procedure #1, Employee Relations Code.

CONFIDENTIALITY/HIPAA/CORPORATE COMPLIANCE
Demonstrates knowledge of procedures for protecting and maintaining security, confidentiality and integrity of employee, patient, family, organizational and other medical information. Understands and supports the commitment of Methodist Hospitals in adhering to federal, state and local laws, rules and regulations governing ethical business practices for healthcare providers.

DISCLAIMER - The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. The statements are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required.