Medical Biller - CBO Hospital Services - AR Follow Up

Job description

Your job is more than a job Why a Great Place to Work: You’re more than your job. Everyone is. And that’s what makes you great at your job—all the little extras you bring to work every day, the things that make you you . At LCMC Health we value those things about you, because we know that all those little extras add up to extraordinary. And we’ve built a culture that supports and celebrates the extraordinary. You’ll see it when you come to work here, in the spirit of our places and the faces of our people. And every patient we heal, every family we comfort, every life we improve is the outcome of countless little extras adding up to an extraordinary result. Join LCMC Health, and you’ll find that our everyday makes it easy to live your extraordinary . Essential Function: The Patient Access Representative will initiate authorization and benefits for patients. They will obtain and verify accurate identification and demographic data for the patient's permanent medical record which assists in accurate reimbursement while recognizing the necessity of maintaining the confidentiality of all patient information. The Patient Access Representative is responsible for obtaining authorization and benefits and interacting with the patients via telephone, and/or using the interpretative service when needed. The Patient Access Representative improves patient satisfaction through consistently representing LCMC professionally and cross-training to support multiple functions across all patient and payer types. They will interact with patients, doctors, pharmacies, nurses, and other clinic or hospital personnel both internal and external. The Patient Access Representative demonstrates actions consistent with LCMC's "Expectations" as duties are performed on a daily basis. Provides Assistance to Patients: Greets patients, guests and family members both on phone or in person. Schedules patients for services with appropriate provider at appropriate locations and desired time when possible, ensuring accuracy and timeliness. Analyzes current patient information to determine if an account already exists so as not to duplicate records Creates an account for all patients who present for services, including walk-in, non-scheduled, and emergency services according to the registration policy. Registers patients by entering accurate demographic, financial class, insurance information; makes revisions to systems immediately as errors are recognized. Activates scheduled accounts that have been set-up for the patient according to the registration policy. Initiates bed placement, reservation, transfer, and/or discharge based on requests from clinical providers, case management, etc. Assists patients with understanding their financial obligations, setting up payment arrangements, completing financial assistance applications, coordinating care with the providers, securing grants/resources with external sources (Drug Therapy Reimbursement) and when necessary, makes appropriate referrals to Parish Medicaid, Medicaid, or Emergency Medicaid. Completes the patient registration and admissions process and ensures all required forms are completed and other paperwork / documents are gathered and accurate: Requests and documents patient demographic, insurance, guarantor, MSP, and PCP/Referring Physician information and validates against current system Ensures patient/guarantor sign all applicable documentation, such as consents and financial assistance loan application Scans ID, insurance cards, orders, authorization information, etc. to patient’s account once the information is validated for accuracy Performs insurance verification tasks, including: running automated eligibility response at point-of-service to ensure active coverage and completing notification of admission with insurance company within established timeframe Contacts case management and/or provider to assist with appropriate department placement for clinical services Analyzes physician’s order for proper bed placement functions per policy when necessary Performs financial analysis of each case and informs patient of financial responsibility: Informs patient/guarantor of liability due, including prior balances and estimates for scheduled service Attempts to collect payment Refers to financial counseling as needed Maximizes point-of-service collection, meeting established registration collection goals Provides excellent customer service to all patients, guests and family members: Promotes a customer centered experience by performing all functions in a warm and courteous manner to patients, family members, providers, and all visitors of the organization. Answers incoming calls and transfers calls to appropriate areas of department/clinic/hospital. Provides directions to applicable areas of interest, such as the department where service will be provided, financial counselor, cafeteria, waiting rooms, restrooms, and parking area. Schedules and reschedules appointments for patients as needed, identifying open time slots and educating patient/guardian about available options for services Job Qualifications: Education A high school diploma or GED required Certification in billing and/or coding is preferred Experience Minimum two years of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management is preferred Strong clerical experience considered Knowledge, Skills, Abilities Must be able to pass basic computer skills test and system level training Working knowledge of system reports and the ability to analyze system information to determine the impact of possible changes Demonstrates knowledge of: Hospital and professional billing processes and reimbursement Third-party contracting Insurance protocols, delay tactics, systems, and workflows ERISA guidelines for denials and appeals Regulations related to denials and appeals Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change Possesses efficient time-management skills and proven ability to multitask under tight deadlines Demonstrates excellent customer service skills Effective writing and communication skills Strong comfort level with computer systems The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. WORK SHIFT: Days (United States of America) LCMC Health is a community. Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary Your extras Deliver healthcare with heart. Give people a reason to smile. Put a little love in your work. Be honest and real, but with compassion. Bring some lagniappe into everything you do. Forget one-size-fits-all, think one-of-a-kind care. See opportunities, not problems – it’s all about perspective. Cheerlead ideas, differences, and each other. Love what makes you, you - because we do You are welcome here. LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Simple things make the difference. 1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information. 2. To ensure quality care and service, we may use information on your application to verify your previous employment and background. 3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed. 4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.