Patient Fin Svcs Rep

POSITION SUMMARY:

This position will oversee Patient Financial Services representative (PFS) staff on second shift who deal with patients regarding any concerns related to billing, self-pay balances, insurance payments, and all other financial matters. This position will also supervise staff regarding collection of patient payments, setting up payment agreements and have expertise knowledge to assist in portal services. The PFS Supervisor will report to the Patient Financial Services Manager at Steward Medical Group (SMG) and assist the PFS Manager in reporting functions and other administrative duties and responsibilities.

KEY RESPONSIBILITIES:

• Monitor how staff is managing work queues and worklists in patient billing system
• Monitor staff shift schedule and approve time off requests to ensure appropriate coverage
• Act as subject matter expert and “go to” person regarding systems, policies and work flows
• Will monitor and reassign some staff duties as necessary based on inbound call volumes and other work load volumes
• Ability to coach staff in order to maintain preferred organization standards
• Monitor staff performance metrics for QA based on established standards for the department
• Ability to perform staff evaluation process
• Monitor staff compliance with HR policies
• Ability to clearly communicate any changes in policy and procedures and monitor compliance
• Will report any issues to PFS Manager and take any necessary disciplinary actions related to and based on expected levels of performance
• The supervisor will be responsible for training of new staff
• Assist in preparation of monthly package for leadership to include and track top trends, call metrics, current issues and plan of action taken
• Handle escalated issues from staff for patients wishing to speak with someone of authority
• Ensure staff is provide patients with World Class service and foster proper environment
• Update patient insurance, confirming eligibility and queue claims for billing
• As needed will provide backup to answer incoming phone calls depending on daily responsibilities.
• Update demographic and guarantor information in the Patient Accounting System
• Act in a professional manner and treat patients, co-workers, and leadership with respect at all times
• Supervisor will ensure that staff will perform and have the ability to:

-Troubleshoot and identify patient billing issues to resolve them to patient’s satisfaction

-Ability to explain and discuss SMG and PFS policies for better patient understanding

-Educate patients about third party and insurance processes, their plan benefits, and how they affect patient balances

-Evaluate accounts from both an insurance and self-pay perspective

-Evaluate accounts for self-pay refunds

-Advocate for patients and contact insurance companies on their behalf, when necessary, to resolve disputes

-Assist with patients with access to the Patient Portal and password resets

-Set up payment plans, monitor and make outbound calls to patients with broken promise to pay agreements

-Ability to approach patient and discuss open, unpaid or overdue balances

-Receive and process patient credit card payments, and allocate to appropriate visits on the account

-Evaluate target accounts above designated thresholds for bad debt placement, and work with bad debt vendor on patient issues and concerns

-Post appropriate discounts and adjustments to patient accounts

• Interact with supporting departments; coding, cash-ops, AR follow up to resolve billing and payment issues
• Interact with Practices to communicate and work cooperatively regarding patient billing issues
• Maintain expected performance metrics
• Other duties as assigned

REQUIRED KNOWLEDGE & SKILLS:

(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)

• Knowledge of insurance rules/regulation and policies
• Manage and motivate staff to perform duties and achieve department goals
• Professional Working Revenue Cycle experience in either an AR follow up, Cash-Ops, denial management or self-pay role
• Ability to multitask, communicate and follow through with our patients and other contacts effectively in a concise manner, in order to bring issues effectively to a resolution and bring tasks to completion satisfactory to all
• Ability to identify billing trends affecting patient balances
• Ability to evaluate situations and escalate issues appropriately
• Ability to multitask, and ability to follow through with our patients and contacts
• Ability to read, understand and interpret insurance Explanation of Benefits
• Prior experience with Athena preferred
• Experience with Excel, Word and Outlook required
• Organizational, time management skills
• Ability to think globally about the patient experience

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

Education: Associates degree or relevant work experience required

Experience (Type & Length): Medical billing, preferably in a professional setting, required

Certification/Licensure: N/A

Software/Hardware: Athena and Meditech experience preferred

Other: Minimum 3 years previous supervisory experience of groups of 10 or more in a professional health care setting