Patient Account/Customer Service Rep-Self Pay and Bad Debt

• Works self-pay credit balances and resolves.
  

• Prepares Medicare Bad Debt schedule and maintains on a monthly basis. Gathers and stores collection efforts backup and proof to insure bad debt reimbursement.

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  Acts as hospital liaison for all outsourced account activity – enters and updates account information as received and routes for appropriate action – rebill, adjustment, financial assistance, closure, etc.

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  Produces monthly reporting of outsourced activities performance.
• Compares to prior periods and established benchmarks.

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  Monitors assigned work lists at all sources and insures expeditious resolution. Works with other departmental representatives in resolve. Reports unresolved issues and concerns impeding the collection process and to ensure successful account resolution.

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  Complies with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information.

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  Seeks advice and guidance as necessary to ensure proper understanding.

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  Performs other duties as assigned by the Supervisor.

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  Handles telephone information with courtesy, accuracy, and respect for confidentiality; receives information and distributes messages appropriately.

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  Consistently communicates appropriately with patients and staff and responds to requests for assistance promptly.

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  Provides accurate communication in verbal, nonverbal and written form. Listens effectively.

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  Communicates effectively with supervisor, including but not limited to changes of operation. Reports to supervisor regularly on the status of ongoing projects.

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  Assists with orientation of new staff.

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  Follows proper chain of command appropriately to resolve problems and concerns.

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  Treats patients and their families with respect and dignity, and ensures confidentiality of patient records.

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  Provides positive and productive support to the team and promotes teamwork. Is kind, courteous, respectful and professional in all interactions with all hospital personnel at all levels.

Serves as coverage for incoming calls both from internal sources as well as external sources and routes appropriately.

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  Determines nature of call and routes to the appropriate person or ascertains a clear and concise accounting of the nature of the call and documents same in patient file notes.

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  Reviews account with patient and if problem resolution is evident, responds accurately and appropriately or research account. This could include but not limited to researching insurance billing information, reviewing postings for mathematical accuracy, pulling and reviewing explanations of benefits, reviewing contractual terms to determine if applied accurately.

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  Determines nature of problem. Reviews with appropriate personnel and forwards for proper approvals if resolve is not within the authority of the representative.

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  Enters into Patient Accounting System new information provided by the patient and/or guarantor

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  Provides application for charity care/financial assistance when appropriate.

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  Authors and routes correspondence

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  Requests rebills as necessary

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  Pull explanation of benefits as needed to respond to customer inquiry

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  Complies with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information.

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  Seeks advice and guidance as necessary to ensure proper understanding.

Provides General office support – opens and distributes mail per established policy and procedures.