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 regulatory and accreditation standards.

Responsibilities:

1. Consistently meet productivity and quality standards in timely resolution of claim edits, reporting candidates for bill, outbound compliant claim submission, clinical documentation requirements, and communications regarding claims to ensure timely filing of clean, complete, and accurate claims.
2. Meet or exceed productivity standards, targets, error ratios, and reporting requirements assigned by the Patient Accounting Lead Financial Assessor and Operations Coordinator.
3. Follow-up and collect third-party payer receivables.
4. Handle denials and appeals, including root cause analysis to reduce/prevent future denials and work to overturn denials for payment resolution.
5. Follow-up with compliant correspondence to third-party payers regarding outstanding accounts receivables (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 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 with appropriate justification and documentation.
10. Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices.
11. Provide individual contribution to the overall team effort of achieving department accounts receivable goals.
12. Identify opportunities for customer, system, and process improvement and submit to management.
13. Follow NMHC general Policy and Procedures, Departmental Policy and Procedures, and Emergency Preparedness Procedures.
14. Follow Joint Commission and outside regulatory agency rules and procedures.
15. Utilize assigned menus and pathways in hospital mainframe system and report software application problems to the appropriate supervisor.
16. Utilize assigned menus and pathways in external software applications and report software application problems to the appropriate supervisor.
17. Utilize assigned computer hardware and report hardware problems to the appropriate supervisor.
18. Participate in testing for assigned software applications, including verification of field integrity.
19. Assist the Patient Accounting Operational Coordinator and Patient Accounting Team Lead Financial Assessor with special projects and other duties as assigned.
20. Attend training and seminars as assigned.

Additional Responsibilities:

• Demonstrate excellent customer service through oral and written communication.
• Demonstrate proficient use of systems and execution of processes.
• 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.

Required:

• High School diploma
• One year related work experience or college degree
• Ability to perform mathematical calculations
• Basic knowledge of medical terminology and billing practices
• Extensive experience and knowledge of PC applications (Microsoft Office and Excel)
• Ability to learn quickly and meet continuous timelines
• Exhibit behaviors consistent with principles of excellent service

Preferred:

• Two or more years’ college or college degree
• Call center, telephone work experience or cash collections experience
• Knowledge of Epic Systems
• Two years progressive work experience in a hospital/physician billing or SBO environment
• Detail-oriented, good organizational skills, and ability to be self-directed
• Strong time management skills, managing multiple priorities and a heavy workload
• Flexibility to perform other tasks
• High-level problem-solving, analytical, and investigational skills
• Excellent internal/external customer service skills

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