Summary:
The Self-Pay Billing and Follow-Up Specialist is responsible for resolving self-pay accounts while maintaining strong relations with patients, guarantors, and business office departments. This individual utilizes behavioral health billing knowledge and excellent customer service skills to effectively collect from and provide financial resources to patients, thereby promoting patient satisfaction and Rogers Behavioral Health financial solvency.
Job Duties & Responsibilities:
- Handles all communication (telephone, email, and written correspondence received through mail). with patients and other departments within the organization to resolve outstanding self-pay balances in a prompt, courteous, respectful manner.
- Provide exceptional customer service that aims to improve patient and/or guarantor relations and contribute to a positive work environment and financial bottom line.
- Listens attentively to customer’s needs, demonstrating empathy while clearly explaining the insurance billing processes as well as any financial processes and polices of the organization. De-escalate calls and resolve concerns.
- Negotiate full payment from patients and help them set up agreeable payment plans based on current policies as well as offering any financial assistance that may be available to them.
- Respond to voice mail and email messages from patients, guarantors, and other parties in a timely manner.
- Utilize reports available to continually work at reducing Accounts Receivable and reporting any errors or issues to leadership, focusing on a three-business day turnaround time.
Assist external users of Rogers services by answering questions and solving problems involved in their use
- Confirm patients, guarantors, and other parties understanding of the solution and provide additional customer education as needed.
- Brainstorm with the team to develop ideas to resolve problems to better serve the patients and/or improve productivity.
Make follow-up outbound calls to patients, guarantors, and other parties as a part of case resolution, adhering to all HIPAA laws, within an acceptable established timeframe
- Meets position goals and objectives related to accuracy, productivity, e.g., days on Account Receivable, cash collections, avoidable write offs and reimbursement metrics.
- Engage in continuous professional development by attending staff meetings, educational seminars, and workshops.
- Perform other duties as assigned.
- Promote department goals as well as the mission of Rogers.
- Communicate goals to fellow staff members.
- Demonstrate measurable goal achievement.
- Maintain department policies and procedures.
- Include requirements and guidelines from external agencies (i.e., Joint Commission, State of Wisconsin).
- Maintain and/or communicate to appropriate party function backlog at a set time.
- Educate inexperienced staff regarding regulations or requirements of those functions that relate to their areas or departments, as directed.
- Demonstrate acceptance and training of student interns in the department, as directed.
Demonstrate understanding of Joint Commission and other regulatory agency compliance regulations
- Involve self in the learning and application of standards relevant to the department.
- Participate in services, seminars, and other meetings to increase involvement and awareness of regulations.
- Involve self in the education of other disciplines regarding the department’s regulations.
Participate in Rogers committees, performance improvement team meetings, and team projects, as directed
- Demonstrate punctuality and preparedness.
- Demonstrate effective communication skills.
- Demonstrate good organizational skills.
- Contribute in a positive, solution-focused manner.
- Attend marketing department meetings as needed, actively participate in discussions, recognize and contribute to activities leading to improvement.
Participate in the performance improvement program
- Gain understanding of the performance improvement process.
- Apply the performance improvement model to your department’s activities.
- Participate and/or create performance improvement teams that lead to improvement in other hospital areas.
- Educate and involve self in the hospital and department’s performance improvement plans.
Conduct self in a professional manner
- Demonstrate organizational skills that promote timely response to all inquiries and to task completion.
- Communicate with all individuals in a positive and professional manner.
- Attempt to resolve individual issues with peers in a positive, calm manner, with a focus on solution.
- Communicate concerns and provide solutions for same.
- Attend outside seminars and/or educational classes to promote professional growth.
- Demonstrate a positive and professional attitude toward parties outside Rogers (provider relations representatives, managed care contractors, visitors, vendors, etc.).
- Comply with Rogers’ policies and procedures, including Human Resources, Infection Control, and Employee Health policies and programs.
- Project a professional image by wearing appropriate, professional attire.
Additional Job Description:
Physical/Mental Demands:
- Exceptional verbal and written customer service and interpersonal communication skills.
- Ability to multitask and manage time effectively.
- Function with a great deal of autonomy as well as with a team.
- Verbal and hearing ability required to interact with patients and employees. Strong numerical ability required to maintain records and quickly assist patients with their billing questions.
- Tact required to interact effectively with employees and professional staff. Logical thinking and discretion required to make decisions in initiating and implementing policies, procedures, and standards.
- Must be able to read and communicate through written, verbal, and auditory skills and abilities.
- Physically/Mentally able to perform job duties as verified by a physical exam by a licensed physician, per post-employment physical. Ability to travel by car and sit for long lengths of time.
Education/Training Requirements:
- High school diploma or GED, required, Associate degree in Healthcare Administration or related field is a plus.
- Minimum one to two (1-2) years’ experience in a clerical, customer service role required, with experience in healthcare negotiation/collections preferred.
- Must have full understanding of customer service and insurance follow-up processes (i.e., billing, collections, managed care, Medicare, Medicaid, and commercial practices) and well-developed people skills.
- Proven working knowledge of explanation of benefits (EOB), CPT, HCFA, UB04, authorizations/referrals and revenue cycle workflow.
- Intermediate computer skills, use of Microsoft Office Suites.
- Valid Wisconsin driver license. Must be granted insurable status by the Rogers Memorial Hospital insurance policy.
With a career at Rogers, you can look forward to a Total Rewards package of benefits, including:
- Health, dental, and vision insurance coverage for you and your family
- 401(k) retirement plan
- Employee share program
- Life/disability insurance
- Flex spending accounts
- Tuition reimbursement
- Health and wellness program
- Employee assistance program (EAP)
Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Rogers Behavioral Health. To link to the Machine-Readable Files, please visit Transparency in Coverage (uhc.com)
