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Billing Rep

4 months ago


Pasadena, United States Common Spirit Full time

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S., from clinics and hospitals to home-based care and virtual care services, CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources, CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen, both inside our hospitals and out in the community.

Responsibilities

Responsible for identifying and collecting patient financial obligation for the duration of stay as well as verifying the eligibility/benefits information for the patient's visit. will also determine eligibility for the hospital's various financial assistance programs.

1. Performs collection Functions and financial assistance for payment methods

2. Conducts interviews with patients and/or family members

3. Collect and/or negotiate point of service payments or link to financial assistance programs

4. Must be capable of articulating information in a courteous, clear and informative manner to patients, guarantors, family members, clinical staff, other hospital personnel, vendors, physicians, and their office staff

5. Convey estimates of the patient responsibility portion of the billed cost of service to patients under deductible, coinsurance, and standard co-pay benefit designs based on established charge estimates for common procedures

6. Counsels patients regarding their third-party coverage, financial responsibility, and billing procedures

7. Review patient account summaries of unbilled charges, billing, payments, and collection activities

8. Obtain all forms required for patients potentially qualifying for financial assistance

9. Review and monitor accounts for inpatients and initiate proper action

10. Ensures payers are listed Accurately, pertaining to primary, secondary, and/or tertiary coverage and billing when a patient has multiple third party/governmental payers listed on an account.

11. Process patient accounts and deploy established policies to resolve insurance issues with patient accounts with/without supervision i.e. conference calls with employer, payer and physician office staff

12. Initiate pre-cert for in-house patients when required, obtaining pre-certification reference number, approved length of stay, and utilization review company contact person and telephone number

Qualifications

* High School Diploma/GED
* One (1) years of experience
* Excellent customer service skills
* Excellent Written/verbal communication skills
* Math skills
* Computer literate
* Detail oriented
* Basic knowledge of medical terminology
* Knowledge of HMO's , PPO's, Commercial/Governmental payers and System/Entity specific hospital contracts with Third Party payers
* Basic knowledge of HIPPA and EMTALA