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Collector Self Pay I - Business Service-Managed Care (Costa Mesa, CA, US)

Company: Hoag Memorial Hospital Presbyterian
Location: Costa Mesa
Posted on: June 12, 2021

Job Description:

Job Summary:

  • Addresses all incoming inquiries from any customer; patient, insurance company, Hoag employee, whether by telephone, mail or in person.
  • Documents all activity in the facility's legacy, Patient Accounting System.
  • Is familiar with Medicare secondary payer (MSP), Medi-Cal and other government programs, in order to refer patients for financial assistance.
  • Is familiar with the facility's charity and payment plan options, in order to assist the patient without third-party coverage.
  • Contacts patients regarding self-pay balances on the accounts receivable to evaluate patient's ability to pay and collect monies due to the hospital

Essential Functions:

Collector, Self-Pay Specialist Level I includes but is not limited to the following:

  • Assists patients with billing inquiries and insurance questions communicate findings in a professional manner.
  • Contacts patients/guarantors to secure payment for services provided.
  • Documents all calls and actions taken in the appropriate systems. Sets next work date if follow-up is needed.
  • Confirms/updates with patient/guarantor insurance and patient demographic information.
  • Makes appropriate changes and submits/re-submits claims as indicated.
  • Informs patients/guarantors of opportunities for financial assistance, including Medi-Cal/MSN and other available governmental or private programs.
  • Accurately code insurance plan codes, update current payer being billed and request an 837 as appropriate.
  • Is familiar with the financial assistance program to provide patient/guarantor assistance with completion when appropriate.
  • Establishes a payment arrangement when patients are unable to pay in full, at time of payment is due This may include installment plans and patient settlements, in accordance with Hoag policies.
  • Patient complaints/disputes are documented and forwarded to the supervisor.
  • Responsible for following all collection policies and procedures.
  • Meets quality assurance and productivity standards.
  • Returns all voice mail messages/emails on the same day received.
  • Generates itemized bills as needed to any customer, internal or external.
  • Assists with distribution, review, and work of incoming faxes, amended orders and other inquiries received via fax or other assignments during zero calls in queue.
  • Takes part in all training about third-party requirements.
  • Participates actively in any training opportunities to enhance knowledge to help Hoag patients.
  • Accurately sets up payment plans, updates to the accounts or other necessary updates inaccurately in all applicable systems.
  • Ability to review and identify applicable cash rates, special rates, applicable professional and employee discounts based on policies and procedures.
  • Demonstrates knowledge and is able to process bankruptcy and deceased patient accounts.
  • Performs other duties as assigned

Education, Training and Experience

Required:

  • High School graduate or equivalent.
  • Understanding of hospital reimbursement methodologies, including DRGs, APCs, and standard payment methodology.
  • Strong customer relation skills.
  • Ability to communicate well both verbally and in written form.
  • Ability to interact with all levels (patients, hospital staff, physicians, vendors)

Skills or Other Qualifications

Required:

  • Expert knowledge of self-pay collection techniques.
  • Working knowledge of Medicare, Medicaid, and all other third-party payment methods.
  • Effective written and verbal communication skills.
  • Excellent customer service skills and telephone etiquette.
  • Problem-solving skills essential.
  • Insurance knowledge and communication with payers.
  • Ability to think independently and use good judgment for situations which require initiative and innovation.
  • Computer literacy, including proficiency in Word and Excel, some knowledge of Access (preferred).
  • Knowledge of basic office equipment.
  • Ability to establish work priorities and prioritize needs to meet required timelines.
  • Analytical and problem-solving skills.
  • 10 Key by touch and ability to type 40 WPM.
  • Basic math calculation skills

Preferred:

  • Bilingual English and Spanish

Keywords: Hoag Memorial Hospital Presbyterian, Costa Mesa , Collector Self Pay I - Business Service-Managed Care (Costa Mesa, CA, US), Other , Costa Mesa, California

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