Denial Management Specialist
Job Description
GENERAL
Summary:
Under the direct supervision of the Senior Business Services Manager, the Patient Account Representative is responsible for providing outstanding customer service to patients and their families, assuring the patients and families understand financial responsibilities, setting up budgets, and posting payments to accounts in accordance with the Clinic s policies. This position will also provide information about various state assistance programs to patients and families then guide eligible individuals in the application process.
GENERAL
Responsibilities:
1.Provide professional and courteous service to all customers of Ogden Clinic. Customers include all patients of Ogden Clinic and its affiliates, providers, administration, employees, co-workers, insurance company representatives, and all other vendor representatives.
2.Meet behavioral expectations and support the dignity of all persons. Also responsible for the stewardship of resources.
3.Ensure applicable regulatory requirements are complied with and follow guidelines that maintain safety for oneself, patients, visitors, and co-workers.
4.Study, understand, and adhere to all Clinic Policies and Procedures.
5.Maintain an adequate level of productivity, as defined with the Manager.
ESSENTIAL JOB FUNCTIONS:
1.Confirm patient insurance eligibility and/or benefits.
2.Post patient payments to proper accounts.
3.Generate patient statements and respond to amount inquiries.
4.Answer incoming phone calls.
5.Provide customer service to patients inquiring about statements.
6.Set up and maintain budget plans with patients.
7.Determine required deposits and follow-up to ensure payments were made in accordance with Clinic policies and procedures.
8.Correct outdated addresses in eClinicalWorks (ECW) patient account and maintain address log.
9.Adjust outstanding or bounced patient checks and enter notes into practice management system.
10.Discuss and educate family members on various services offered by the Clinic and methods of payment for those services, including but not limited to Medicare, Medicaid, Insurance, and Private pay.
11.Make appropriate adjustments to patient accounts in accordance with Clinic policies.
12.Promptly respond to patient inquiries.
13.Work accounts in an accurate and timely manner processing all collections, refunds, appeals, and adjustments as necessary.
14.Over time, including but not limited to evenings and weekends, may be required.
OTHER DUTIES:
1.Assist with special projects as needed.
2.Maintain confidentiality of patient records and employee/co-worker information.
Qualifications:
1.EDUCATION: High School Diploma or general education degree (GED).
2.LANGUAGE SKILLS: Able to read and interpret documents such as safety rules, operating and maintenance instructions, procedure manuals, EOB s, and Insurance Claims forms.
3.Effectively manage multiple tasks simultaneously.
4.Computer knowledge with experience in basic word processing and spreadsheet programs required.
5.General office equipment and procedure knowledge helpful.
DISCLAIMER CLAUSE:
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and intensity of the job.Estimated Salary: $20 to $28 per hour based on qualifications.
GENERAL
Summary:
Under the direct supervision of the Senior Business Services Manager, the Patient Account Representative is responsible for providing outstanding customer service to patients and their families, assuring the patients and families understand financial responsibilities, setting up budgets, and posting payments to accounts in accordance with the Clinic s policies. This position will also provide information about various state assistance programs to patients and families then guide eligible individuals in the application process.
GENERAL
Responsibilities:
1.Provide professional and courteous service to all customers of Ogden Clinic. Customers include all patients of Ogden Clinic and its affiliates, providers, administration, employees, co-workers, insurance company representatives, and all other vendor representatives.
2.Meet behavioral expectations and support the dignity of all persons. Also responsible for the stewardship of resources.
3.Ensure applicable regulatory requirements are complied with and follow guidelines that maintain safety for oneself, patients, visitors, and co-workers.
4.Study, understand, and adhere to all Clinic Policies and Procedures.
5.Maintain an adequate level of productivity, as defined with the Manager.
ESSENTIAL JOB FUNCTIONS:
1.Confirm patient insurance eligibility and/or benefits.
2.Post patient payments to proper accounts.
3.Generate patient statements and respond to amount inquiries.
4.Answer incoming phone calls.
5.Provide customer service to patients inquiring about statements.
6.Set up and maintain budget plans with patients.
7.Determine required deposits and follow-up to ensure payments were made in accordance with Clinic policies and procedures.
8.Correct outdated addresses in eClinicalWorks (ECW) patient account and maintain address log.
9.Adjust outstanding or bounced patient checks and enter notes into practice management system.
10.Discuss and educate family members on various services offered by the Clinic and methods of payment for those services, including but not limited to Medicare, Medicaid, Insurance, and Private pay.
11.Make appropriate adjustments to patient accounts in accordance with Clinic policies.
12.Promptly respond to patient inquiries.
13.Work accounts in an accurate and timely manner processing all collections, refunds, appeals, and adjustments as necessary.
14.Over time, including but not limited to evenings and weekends, may be required.
OTHER DUTIES:
1.Assist with special projects as needed.
2.Maintain confidentiality of patient records and employee/co-worker information.
Qualifications:
1.EDUCATION: High School Diploma or general education degree (GED).
2.LANGUAGE SKILLS: Able to read and interpret documents such as safety rules, operating and maintenance instructions, procedure manuals, EOB s, and Insurance Claims forms.
3.Effectively manage multiple tasks simultaneously.
4.Computer knowledge with experience in basic word processing and spreadsheet programs required.
5.General office equipment and procedure knowledge helpful.
DISCLAIMER CLAUSE:
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and intensity of the job.Estimated Salary: $20 to $28 per hour based on qualifications.
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