Job Location : Laconia,NH, USA
Pay Range: $20.45 - $29.66 hourly Summary Working under the supervision of the Customer Service Manager, the Patient Account Resolution Specialist is the hospital's primary resource for all aspects of revenue management, with a focus on self-pay billing. Answering phone calls is a component of this job; however, a majority of our calls are handled by outside vendors. The individual in this role is responsible for Identifying, researching, and resolving sensitive and complicated customer questions and issues that have been escalated by our internal and external stakeholders. These include, but are not limited to: bankruptcy encounters, Patient Relations/Risk questions, questions from CHMG practices and hospital departments, escalated calls and internal reviews from our vendors, insurance management, legal and bad debt requests and follow up, recall reports, recon reports, settlement requests, special programs, and uncollectable encounters. Producing Good Faith Estimates as part of the No Surprises Act and cost of care estimates as part of Price Transparency are important responsibilities of this role. In addition, the individual in this role will be responsible for auditing the quality of our vendor's work as well as reporting and acting on the audit results. The Patient Account Resolution Specialist demonstrates proficiency with complex regulatory and managed care mandates, third party contract requirements, multiple software and electronic systems and/or processes as well as detailed departmental policies and procedures in order to effectively carry out the revenue management functions of the organization. Hours 8:00 am - 4:30 pm Education Two years of formal training or education beyond the high school level or two years of related experience and/or training; or equivalent combination of education and experience. Bachelor's preferred. Certification, Registration, and Licensure None required. CRCR preferred. Experience The candidate must have a minimum of five years' experience in healthcare revenue operations, preferably in the hospital or medical office setting. Proven mastery of all aspects of the revenue cycle, including: scheduling, registration, financial counseling, charge capture, claim submission, insurance management, claim follow up, transaction posting, reimbursement, customer service, collections, and bad debt management. Must be familiar with medical terminology, medical records, and have some knowledge of healthcare coding systems, including ICD-10, CPT, and HCPCS. Must demonstrate a commitment to providing excellent customer service, the ability to maintain composure in fast-paced and stressful situations, a pleasant and positive attitude, and neat appearance. Must have excellent communication, telephone, and computer skills. Must be able to successfully manage multiple priorities and deadlines. Must be self-motivated with the ability to succeed in an autonomous position. Must have a basic knowledge of state, federal, and third-party billing/registration regulations and requirements with the ability to keep current on regulatory updates. Must have the knowledge and confidence to handle complex patient billing questions and issues. Responsibilities