CareCentrix

  • Patient Account Specialist

    Job Locations US-FL-Tampa
    Job ID
    2018-6460
    Category
    Billing & Collections
  • Overview

    If you're excited by the idea of being a part of a dynamic healthcare organization that improves patients' lives by delivering innovative home health solutions, then come join our team!  CareCentrix is commited to making the home the center of patient care. The patient account specialist job will determine the acceptance of patient’s financial responsibility through claim research, plans, eligibility, notes, etc.; goal to resolve patient’s account. Guides collectors in their performance of invoice processing activities to ensure receivables are reimbursed in an accurate and timely basis. Works directly with the payer, internal and external customers and other contract clients towards efficient and effective collection results.  

    CareCentrix offers competitive pay and a full benefit package including health, dental, vision, 401K, and tuition reimbursement.  

     

    Collections Job responsibilities

    • Ensures the coordination of invoice activities leading to timely reimbursement of receivables using available resources including databases, internet, and telephone.

    • Researches and resolves denials received that have not passed payer edits and may lead to a final appeal of denied services. Requires knowledge of a variety of system applications both internal and external. Determines and initiates action to resolve rejected invoices, prepares payer corrections, and/or appeals using electronic and paper processes.

    • Oversees accounts receivable adjustments to resolve overpayments and payment rejections according to standard operating procedures. Analyzes and clears payment variances. May prepare adjusted and corrected bills or adjust accounts receivable entries in accordance with existing operating procedures. May include the use of special reporting.

    • Contacts providers, physicians, and/or patients to retrieve appropriate medical documentation to substantiate services provided and engage them in assisting CareCentrix in collecting for the payer.

    • Provide payers with detailed itemization of services performed to ensure timely reimbursement.

    Review EOPs/EOMBs/EOBs for accuracy of patient responsibility.

    • Provide input on accounts receivable process improvements and assisting in their implementation.

    • Prepares Ad Hoc financial reports for management to use in the evaluation of accounts receivable performance.



    Patient Account Job Responsibilities

    • Researches, resolves, and documents patient inbound and outbound calls involving a wide range of issues utilizing multiple information systems. This includes communications with internal business centers and external customers. Assures customer agreement by summarizing and closing each call appropriately. 

    • Investigates payment status and determines ultimate patient financial responsibility. Collect outstanding balance, offer patient assistance with financial responsibility through various financial options.

    • Identifies overpayments, processes refunds, adjustments, and appeals as necessary. Analyzes and resolves payment variances, which may involve preparation of adjusted and corrected bills, or adjusting accounts receivable entries in accordance with existing operating procedures. This may include the use of special reporting.

    • Minimizes patient dissatisfaction by listening attentively, maintaining a professional tone, and acknowledging their concerns. Escalates patient issues and concerns to the appropriate senior.

    • Reviews payer payment explanation for accuracy of patient responsibility.

    • Maintain patient confidentiality and data integrity in accordance with Health Information Portability Accountability Act (HIPAA), and company policies and procedures.

    • Sends patient necessary documentation required to complete the payment arrangement process. Prepares payment plan agreements or other correspondence; including requests for secondary payers or Medicare/Medicaid verification or other documentation necessary to resolve open account issues. Assures patients return documentation or signed payment agreements.

    • Takes appropriate action when patient requests assistance in reconciling their financial responsibility, including proper follow up.

    • Participates in special projects and performs other duties as assigned.

    Qualifications

    • Requires a HS diploma or equivalent; up to 1 year of previous related experience; or any combination of education and experience, which would provide an equivalent background. 
    • Two years medical claims processing and reimbursement experience generally required. Knowledge of healthcare collection procedures and related internal and external software applications are required.
    • Effective analytical, verbal and communication skills also required as well as knowledge of HIPPA, The Fair Credit and Collections Act, HCPC, CPT, ICD-9 coding, intermediate competency of Microsoft Office Applications, and mathematical calculations.
    • Knowledge of Utilization Management and URAC standards. Basic competency of Microsoft office applications and mathematical calculations is required.
    • Must be well organized and possess excellent time management skills.  

    We at CareCentrix know that our work matters and that we make a difference. We take pride in what we do and truly believe that our most valuable assets are our employees

    CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.

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