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Natividad Medical Center (NMC) · 4 months ago

Patient Financial Services Specialist II

Greater Salinas Area

Full-time

Onsite

Entry Level

1+ years exp

Natividad Medical Center is currently seeking to fill a permanent full-time Patient Financial Services Specialist II position. The role involves preparing patient accounts, generating bills for services, and interviewing patients to evaluate their financial resources and establish payment terms.

Health CareHospitalMedicalMental Health

No H1B

Responsibilities

Reviews, verifies, obtains and corrects patient financial status and payor source information, medical diagnosis, laboratory and other diagnostic services information, hospital/clinic services and supplies, applicable dates, required authorizations and certifications, signatures, and other information related to preparation and processing of patient bills, and eligibility for coverage

Enters data into and operates a computerized patient account system

Researches and resolves missing or conflicting information

Interviews and works with patients, families, and others regarding financial resources, eligibility for coverage, status and basis of charges, payment requirements, payment plans, collections, and related matters, in person, by telephone and by letter

Works with other service providers, claim adjudicators, insurance companies, private payors, governmental payor sources, the County Revenue Recovery Division, and others to obtain, correct or provide information; verify eligibility; process patient accounts; verify procedures; initiate collection and/or resolve disputed, unprocessed, and other claims requiring follow-up

Assembles pre-billing materials; prepares, generates and sends individual, insurance, governmental, crossover, and other bills for medical care related services; evaluates, modifies and resubmits bills

Evaluates and processes bad debt accounts; performs collection and follow-up activities; refers uncollectible accounts to collection services

Requests completion of additional forms or information for denied claims or special processing requirements

Reconciles accounts; posts payments; adjusts balances to reflect denials, adjustments, shares-of-cost, payments, and other modifications to balances; prepares refund packages for approval

Reviews billing documentation; resolves issues that would prevent accurate, prompt claim billing

Runs computerized reports to search for missing or conflicting information

Troubleshoots download problems; communicates problems and recommendations to supervisor for approval

May work in a specialty area such as pre-billing, billing, or collections

Qualification

Patient billing proceduresInsurance requirementsData entry skillsMedical terminologyCPT coding proceduresClerical bookkeepingGeneral office practicesEffective communicationProblem-solving skills

Required

A combination of experience, education, and/or training which substantially demonstrates the following knowledge, skills and abilities:

Thorough Knowledge Of: Federally Qualified Health Center billing procedures and operations

Thorough Knowledge Of: Insurance, other private workers compensation, governmental and special payor requirements, procedures, codes and forms

Thorough Knowledge Of: Hospital/clinic billing procedures and operations

Thorough Knowledge Of: Sources and eligibility requirements for publicly-funded medical care payment programs

Working knowledge of: Clerical bookkeeping practices and procedures

Working knowledge of: General Clerical Office Practices and procedures, including operation of common office equipment and filing systems

Working knowledge of: Current Procedural Terminology and other reference and resource materials related to patient account activities

Working knowledge of: CPT coding procedures

Some knowledge of: Basic Medical Terminology and/or medical billing operations

Some knowledge of: Personal Computer operations

Skill and Ability to: Perform arithmetical computations, comparisons and postings rapidly and accurately

Skill and Ability to: Perform data entry on a computer key board quickly and accurately

Skill and Ability to: Operate a 10 key adding machine quickly and accurately

Skill and Ability to: Accurately match and file materials using alphabetic and numeric systems

Skill and Ability to: Read and apply complex procedures and regulations

Skill and Ability to: Establish and maintain effective working relationships with a variety of individuals under potentially hostile or emotional circumstances

Skill and Ability to: Assemble pre-billing packages and prepare bills

Skill and Ability to: Evaluate, determine and approve eligibility for specialized publicly-funded medical care payment programs

Skill and Ability to: Prepare medical billing for electronic billing submission

Skill and Ability to: Evaluate patient payor sources; and follow-up on past due accounts

Skill and Ability to: Evaluate, determine and approve eligibility for specialized publicly-funded medical care payment programs

Skill and Ability to: Operate a patient accounts computer system

Skill and Ability to: Evaluate patient financial status and payor sources, establish payment plans and follow-up and collect past due accounts

Skill and Ability to: Read and apply complex procedures and regulations

One (1) year of experience performing duties directly related to patient account billing, patient financial resources evaluation, account collection or assessment of patient eligibility for specialized medical care financial programs

OR One (1) year of experience at a level equivalent to Monterey County's Account Clerk

OR Two (2) years of experience equivalent to Monterey County's Patient Financial Services Specialist Representative I

Natividad requires that all incumbents pass a pre-employment physical/medical assessment

Natividad will conduct a thorough background and reference check process which includes a Department of Justice fingerprint check

Employees who drive on County business to carry out job related duties must possess a valid Driver License for the class vehicle driven or have the ability to provide suitable transportation that is approved by the appointing authority

Employees must have and show their original Social Security Card and a valid Driver License or State ID prior to the first day of work (Social Security Card is required for payroll purposes only)

Incumbents may be required to work all shifts, including irregular hours, nights, weekends and holidays

Incumbents may be required to work with potentially hazardous and infectious substances

Company

Natividad Medical Center (NMC)

Voted Best Hospital in the Salinas Valley, Natividad is a hospital and Level II Trauma Center providing compassionate, high-quality health care to everyone, regardless of ability to pay or immigration status.

Founded in 1886

Salinas, California, USA

1001-5000 employees