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Company: MedStar Medical Group
Location: Washington, DC
Career Level: Entry Level
Industries: Not specified
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Description

General Summary of Position
Interacts with patients and/or representatives on a daily basis in providing information associated with medical insurance coverage and financial responsibility. Obtains payer specific details, as necessary, and completes additional payer billing and collections. Maintains a professional and courteous behavior to ensure a positive image within the community served and to promote customer satisfaction.


Primary Duties and Responsibilities

  • Answers and resolves patient/guarantor inquiries (verbal and written) via telephone, in person (in-house and walk-ins) or mail within 24- 48 hours.
  • Attends training sessions and workshops offered, to include but not limited to, CRCS Training, bulletin review, etc. Attends and successfully completes required Continuing Education Units (CEU) for the PFS Training Program. Completes annual mandatory training (SITEL) within defined time frame.
  • Initiates referrals to outside agency for assistance in the Medicaid process when appropriate. Follows-up and monitors all accounts referred to outside agency. Counsels ineligible Medicaid patients or patient representative, as needed.
  • Keeps abreast of regulatory and specific changes as it relates to UB04 and HCFA 1500 billing requirements and payer specific follow up.
  • Maintains daily performance benchmarks as it pertains to providing information associated with medical insurance coverage, financial responsibility, and Medicaid eligibility.
  • Maintains departmental QA standards within established error rate.
  • Meets team specific benchmark as it applies to Self Pay and Medicare Financial screening capture rates, 3808 processes, Medicaid conversion rate and 1184 Baby Name Log.
  • Performs required follow-up with patient and caseworker by obtaining and providing the necessary information to complete the Medicaid application process. Follows specified Medicaid application timeframe guidelines. Advises patient of the need to select a MCO upon receipt of Medicaid eligibility. Assists patient in MCO enrollment process.
  • Screens patient for Medicaid. Obtains promissory notes for charity care application. Notifies and collects deposits (copays, deductible, etc.) from patients. Secures necessary forms or signatures for billing purposes.
    • CUSTOM.PRIMARY.DUTIES.RESPONSIBILITIES.ADDENDUM


     

    Minimum Qualifications
    Education

    • High School Diploma or GED required

    Experience

    • 1-2 years experience in community outreach program or related field required or an equivalent combination of experience and college education in a related field

    Licenses and Certifications

    • State of Maryland Hospital Presumptive Eligibility Certification (HPE) required within 1 year from the date of hire required and AAHAM CRCS-I preferred

    Knowledge, Skills, and Abilities

    • Detailed working knowledge and demonstrated proficiency in multiple payers application billing and/or collection process, with particular focus on State assistance programs, HPE or multiple payers insurance verification and pre-certification guidelines.
    • Basic working knowledge of the Corporate Financial Assistance Policy, UB04 and/or 1500 billing.
    • Excellent communication, analytical, interpersonal and organizational skills.
    • Proficient use of hospital registration and/or billing systems, and Microsoft Word and Excel software applications.


    This position has a hiring range of $20.17 - $35.04

     


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