Description

Requirements

QUALIFICATIONS:

Education and/or Experience

·         High school diploma or equivalent preferred

·         Previous office experience preferred

·         Previous insurance and billing experience preferred

Certificates, Licensure, Registrations

·         For job-specific certifications refer to the Education Certification Requirements by Job Category: Non-Clinical Staff

WORK SCHEDULE & SHIFT REQUIREMENTS:

The facility operates 24/7; however, work schedules may vary based on departmental needs to ensure the highest standard of patient care and operational efficiency. Flexibility will be expected.

• Position is classified as non-exempt and eligible for overtime in accordance with labor laws.

PHYSICAL REQUIREMENTS & WORKING CONDITIONS:

This position involves a combination of physical activities necessary to perform essential job functions effectively. The employee should be able to:

• Sit, stand, and walk for varying lengths of time throughout the workday.
• Lift, push, pull, or carry light to moderate loads, with assistance available for heavier items.
• Use fine motor skills, including grasping, reaching, and handling equipment or materials as needed.
• Perform routine movements, such as typing, writing, or handling supplies.
• Bend, stoop, kneel, or crouch occasionally for job-related tasks.
• See and hear well enough to read documents, operate equipment, and communicate effectively.
• Work in a dynamic environment, adapting to occasional changes in pace or setting.

Reasonable accommodations will be considered to support individuals in performing essential job functions.

Summary

ESSENTIAL JOB DUTIES & RESPONSIBILITIES

At CRHC, our core values—Compassion, Advancing, Relationships, and Exceptional—are at the heart of everything we do. These values drive our commitment to Advancing Exceptional Care, ensuring that we provide the highest quality care to our patients while supporting and empowering our team members. We believe in creating a compassionate environment where relationships are nurtured, collaboration is encouraged, and excellence is expected.

As a member of our team, you will embody these values in your daily work by:

·         Compassion: Demonstrating empathy and kindness in every interaction, recognizing the unique needs of our patients and colleagues.

·         Advancing: Embracing innovation, continuous learning, and striving for improvement in all aspects of patient care and team collaboration.

·         Relationships: Building trust through open communication and teamwork, fostering a supportive atmosphere that prioritizes respect and understanding.

·         Exceptional: Holding yourself to the highest standards, delivering superior care, and contributing to a culture of excellence that impacts both patients and colleagues.

Compiles information to send electronic or hard copy ub64 and 1500 of the patient’s services to the correct agencies.

·         Verifies hospital insurance information.

·         Compiles hospital bills, completes appropriate forms, submit claims to proper agencies/insurance companies.

·         Files claim within a timely filing period.

·         Contacts patients/insurance companies to collect unpaid insurance claims.

·         Appeals claims denied with the proper documentation and time frame allowed for the different agencies.

Keeps current on changes to bill out a claim correctly.

·         Stays informed about changes in Medicare, Medicaid, and commercial insurance agencies so that the hospital complies when billing out claims.

·         Ensures documents being submitted to all agencies are the current standards and policies.

·         Keeps admission staff updated on changes that may affect a claim being processed correctly.

Demonstrates customer service strengths to patients, other staff members and community.

·         Answers the telephone in a polite and helpful manner.  Communicates information to the appropriate personnel.

·         Interacts with patients/families in a professional manner.  Provides explanations regarding statements and insurance coverage.

·         Treats patients and families with respect; ensures confidentiality of patient records.

·         Maintains a good working relationship within the department and with other departments.

·         Maintains a professional working relationship with insurance companies and other entities.

Assists patients, community, and guarantors regarding payment of their account.

·         Explains balances due in an understandable manner.

·         Follows up, corresponds, and documents payment arrangements and delinquent status of accounts on a consistent and timely basis.

·         Follows policies regarding collection, self-pay balances, charity care, write offs and bad debt.

·         Works with attorneys and collection agencies on private pay accounts, delinquent accounts, and legal claims.

Ensures electronic receipting for both clinic and hospital in a complete, accurate manner to ensure timely closing of days.

·         Processes patient statement information to the proper agencies on a weekly basis.

·         Processes patient refunds in a timely manner.

Performs balances daily.

·         Posts receipts to the proper accounts.

·         Balances the receipts to the ledger accounts.

·         Prepares the deposit for the bank.

Quality Program Participation

·         Actively participates in CRHC’s Quality Program, committees, performance improvement initiatives, and operational support activities.

·         Demonstrates a commitment to Quality Improvement (QI) practices.

·         Regularly attends Department huddles.

·         Completes tasks as outlined on the Department Huddle Board.

Other Responsibilities

·         Performs additional duties as assigned to support the strategic initiatives of CRHC.