Full-Time Financial Assessor - Patient Accounting

Financial Assessor - Patient Accounting reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities:

1. Consistently meet current productivity and quality standards in timely resolution of all claim edits, reporting of candidates for bill, outbound compliant claim submission, clinical documentation requirements, and any other communication required (verbal or written) regarding claims ensuring timely filing of claims and clean, complete and accurate claims.
2. Consistently meet or exceed productivity standards, targets, error ratios, and reporting requirements as assigned.
3. Timely follow-up and collection of third-party payer receivables.
4. Denials and Appeals follow-up including root cause analysis to reduce/prevent future denials while working to overturn denials for payment resolution.
5. Compliant follow-up correspondence to third-party payers regarding outstanding accounts receivables (e.g., Statements, letters, emails, faxes, portal mail, etc.).
6. Support operations related to optimum third-party accounts receivables (Managed Care, Commercial, Medicare, Medicaid, Replacement plans, Workers Compensations, Corporate Accounts, Research, and Specialty AR Accounts).
7. Perform daily, systematic reviews of work lists to ensure all accounts are completed.
8. Utilize Government, Commercial, and regulatory guidelines for collection of outstanding accounts.
9. Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation.
10. Demonstrate excellent customer service through oral and written communication in providing assistance/expertise to patients, authorized guarantors, and other external and internal contacts.
11. Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
12. Provide individual contribution to the overall team effort of achieving the department accounts receivable goals.
13. Identify opportunities for customer, system and process improvement and submit to management.
14. Demonstrate proficient use of systems and execution of processes in all areas of responsibilities.
15. Follow NMHC general Policy and Procedures, Departmental Policy and Procedures, and Emergency Preparedness Procedures.
16. Follow JCAHO and outside regulatory agencies mandated rules and procedures.
17. Utilize assigned menus and pathways in the hospital mainframe system and report software application problems to the appropriate supervisor.
18. Utilize assigned menus and pathways in external software applications and report software application problems to the appropriate supervisor.
19. Utilize assigned computer hardware and report hardware problems to the appropriate supervisor.
20. Participate in the testing for assigned software applications, including verification of field integrity.
21. Assist the Patient Accounting Operational Coordinator and Patient Accounting Team Lead Financial Assessor with special projects and other duties as assigned.
22. Attend training and seminars as assigned.

Required:

• High School Diploma
• 1 year of related work experience or college degree
• Working knowledge of physician and facility billing and follow-up, including understanding of insurance rules and regulations (especially Medicare and Medicaid).
• Knowledge of HIPAA standards
• Ability to perform mathematical calculations
• Excellent communication skills
• Basic knowledge of medical terminology and billing practices
• Extensive experience and knowledge of PC applications, including Microsoft Office and Excel

Ability to:

• Learn quickly and meet continuous timelines
• Exhibit behaviors consistent with principles of excellent service
• Demonstrate and maintain competency as required
• Exhibit behaviors consistent with standards of performance improvement and NMHC values

Preferred:

• 2+ years college or college degree
• Call center, telephone work experience or cash collections experience
• Knowledge of Epic Systems, Availity, EQ Health, and Clearing House
• 2 years of progressive work experience in a hospital/ physician billing or SBO environment

Detail-oriented, good organizational skills, ability to be self-directed

Strong time management skills, managing multiple priorities and a heavy workload

Flexibility to perform other tasks as needed

High-level of problem-solving, analytical, and investigative skills

Excellent internal/external customer service skills

Excellent communication skills

Northwestern Medicine is an affirmative action/equal opportunity employer.

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