PATIENT ACCOUNTS SPECIALIST

About the Position: We are looking for a full-time Patient Account Specialist to work in a fast-paced hospital/business office. This position is responsible for the daily posting of patient account payments (check/cash/ACH) from insurance companies and patients. Balance cash posting to bank statement daily. This position is also responsible for the financial counseling for our Outpatient programs. Verify all patient account insurance information prior to or on the day of admission. Contact the patient/guarantor and/or third-party payor(s) to secure insurance eligibility and benefit information. Obtains up-front payment, completes paperwork, and negotiate payment plans while patients are in the facility. Resolve Coordination of Benefit (COB) discrepancies. Daily maintenance of collection spreadsheet. Assures adherence to department quality and productivity standards, expected to work 30+ accounts per workday. Additional compensation provided for achieving established team collection goals.

Payment Posting and Balancing:

• Retrieve and print Electronic Remittance Advices (ERAs)/Explanation of Benefits (EOBs) daily that balance with the bank statement.
• Evaluate ERAs for payment accuracy, making manual adjustments if necessary.
• Clearly and accurately note accounting system of all payment details.
• Process zero payment remits daily.
• Manual payment posting to accounting system.
• Daily balancing of deposit log and monthly cash log.
• Notifies the Business Office Director of any missing ERAs or spreadsheet imbalance.
• Contacts all third-party payor organizations and/or patients as necessary to facilitate the timely gathering of information to ensure accurate daily posting of payments.

Financial Assessment and Coordination:

• Create an exceptional customer experience in person and while handling inbound/outbound customer service calls efficiently while empathizing with customers and navigating systems in a fast-paced environment.
• Utilize knowledge of healthcare reimbursement, medical insurance, and negotiating payment terms.
• Provide benefit education to patients, parents and guarantors.
• Effectively determine and communicate insurance benefits and patient's self-pay responsibilities to patient/guarantor pre-admission.
• Monitors and reviews all new accounts and follow-up documents to determine the accuracy and completion of the information received from the A&R (admissions) Department.
• Notifies the Business Office Director of any delinquent information.
• Contacts all payors to ensure clarification of insurance benefits and any patient responsibility funds due at the time of admission.
• Investigates any delinquent patient information to identify any special circumstances affecting delay of billing with relations to correct information.
• Contacts all third-party payor organizations and/or patients as necessary to facilitate the timely gathering of information to ensure billing credibility.
• Prepares and maintains records and reports documenting the status of all insurance verification and up-front payment collections.
• Maintains current knowledge of all insurance verification policies and procedures and related legislation.
• Promotes a positive working environment and guest relations.
• Assumes and/or performs additional duties as requested.
• Promotes safety by attending mandatory in-services and complies with all safety measures initiated by the facility

About Cedar Springs: At Cedar Springs Hospital, our mission is to deliver the highest quality services to individuals and their families who are dealing with the ramifications of mental illness or substance abuse. Our formula for successful treatment includes innovative services using a level of care that is appropriate to each illness, individually tailored programs and highly qualified mental health professionals. Cedar Springs is dedicated to providing quality, multidisciplinary behavioral health care services to children, adolescents, adults and their families.

As an employee of Cedar Springs we offer the following benefits:

Medical, Vision, Dental, Life Insurance

Short Term/Long Term Disability

Retirement Services

Paid Time Off

Education/Tuition Assistance

Employee Assistance Program (EAP)

Cedar Springs Hospital is in compliance with the Healthy Family and Workplaces Act (HFWA) and Families First Coronavirus Response Act (FFCRA)

Requirements: To perform this job successfully, an individual must be able to demonstrate competency in the criteria listed in this job description. Ability to work independently and part of a team. Experience with medical insurance. Understanding of the revenue cycle and how the various components work together preferred. Working knowledge of Medicare/Medicaid regulations, policies, and procedures. Strong customer service, written/verbal, organizational, and interpersonal skills required. Computer literate/strong computer skills required - especially in Microsoft Word and Excel. The ability to maintain patient confidentiality. Requires ability to exercise independent judgement to accomplish goals and manage time efficiently to meet multiple deadlines. Successful completion of a background check and drug screen required for employment at Cedar Springs Hospital.

Education/Experience : High school education or equivalent. Associate’s degree preferred. Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.