Must be fully vaccinated for COVID-19 including 2 doses of a 2-dose series or 1 dose of a 1-dose series plus 14 days beyond the final dose prior to start date.
Sign On Bonus Eligible - $500!
PeaceHealth is seeking a Patient Account Specialist for a Full Time, Day position. Hourly compensation starts at $17.61, more depending on experience.
Serves as the department lead representing Physician Contracting and Provider Compensation to all PeaceHealth PHMG networks. Responsible for providing compensation analyses, scenario modeling, and guidance which enhances the decision making of assigned internal customers. Works directly with medical group leadership in administering all PeaceHealth Medical Group employed provider contracts and contract revisions ensuring all contract terms are consistent with the PeaceHealth Medical Group Compensation plan, organizational policies, and established legal and financial guidelines. Communicates and works directly with providers in answering compensation related inquiries and serves as a liaison for provider recruiting in resolving contract or compensation related issues. Provides support in the development and reporting for provider compensation, work RVUs and FTEs.
1. Develops and coordinates centralized provider employment contract administration, compliance, processes, and database management. Identifies and analyzes needs and develops processes to support provider compensation policies and practices.
2. Identifies and develops process improvements. Designs, develops, tests and implements electronic auditing and tracking processes. Develops and communicates detailed guidelines and/or changes to the provider compensation processes.
3. Coordinates and audits complex data entered into multiple systems.
4. Provides on-going collaboration with system legal department to establish and maintain contract language and ensure legal and regulatory compliance across all PeaceHealth PHMG networks.
5. Acts as the primary resource for PHMG leadership to provide impact statements, research and resolve pay issues, provide current data, and produce visual communication tools to educate the provider staff and support high quality, high touch service to the provider(s). Provides dissemination of financial information to promote clarity of understanding, effective operational decision making, and ensure an understanding of the financial ramifications of decision alternatives. Provides ongoing financial and variation analysis that will assist management in enhancing operations.
6. Participates in the financial budgeting and general ledger accrual processes for provider compensation. Researches and assists in the design, development and implementation of provider compensation plans, policies and guidelines.
7. Participates in salary surveys, analyzes market data and compiles blended data for the determination of fair market-based compensation and productivity. Develops comparative data used in determining compensation plans.
8. Performs other duties as assigned.
- Bachelor’s degree in Accounting, Finance, Business Administration, Statistics, Human Resources or related field required; or equivalent knowledge and skills obtained through a combination of education, training and experience.
- MHA or MBA is preferred.
- Minimum of five years in the finance and/or human resources compensation field including significant experience with compensation plans is required.
- Working knowledge of CMS Relative Value Units (RVUs) and CPT codes.
- Knowledge of provider compensation and provider contracts.
- Sound analytical skills, including mathematical skills and ability to develop interpret and present data.
- CCP, SPHR or CPA certification is preferred.
- Ability to establish and maintain effective communication and working relationships with providers, medical group leaders, network administrators and recruiters.
- Demonstrated ability to work collaboratively with multiple demands and short time frames
- Excellent verbal, negotiation and written communications skills, particularly with key stakeholder groups such as PHMG leadership, providers and the provider recruitment staff.
- Strong customer service focus. High level of interpersonal skills working in sensitive, personal and confidential situations.
- Advanced level of technical expertise in Excel required with proficiency in Word and PowerPoint.
- Thorough knowledge of business and management principles.
- Strong analytical and organizational skills, high level of accuracy and attention to detail and a proven ability to effectively plan, meet deadlines and work with detail.
- Ability to implement major system and policy improvements and consequent new work flow, procedural systems, and processes.
- Ability to investigate and recommend major problem resolution.
Responsible for working in a call center with patients and/or authorized designees to address payment options, provide insurance setup options and complete related paperwork for both Hospital and Clinic services. Establish and monitor payment arrangements with patients using guidelines established under the collection policy; resolve patient concerns and third party issues to achieve a zero balance account. This position ensures acceptable cash flow and appropriate Days in Accounts Receivable via timely follow-up and resolution of balances owed.
- Identify uninsured or underinsured patients for eligibility for financial assistance through this organization or through government or private programs.
- Perform work in accordance with regulatory requirements, policies/procedures and departmental standards in regards to HIPAA and other government requirements. Ensure that proper billing procedures and privacy guidelines are implemented and carried out.
- Responsible for maintaining daily account, follow-up work lists within department while maintaining organization’s productivity standards.
- Assist patients with the application process for outreach programs and our obligations to maintain certifications as required by the state(s) and/or contractual obligations.
- Respond to customer inquiries in accordance with state and federal laws or applicable internal policies. This response may include charge estimates, clarifying billing practices, correctness of billing and options for resolving private pay balances.
- Communicate appropriately with all customers to include, updating insurance, and routing accounts to appropriate service areas when needed. Handle a high volume of inbound and outbound calls. May leverage an auto dialer system.
- Work directly with responsible party to resolve outstanding patient account activities. Maximize reimbursement through effective collection practices. May receive and post patient payments over the phone, or electronically. Process refund requests as appropriate.
- Review accounts for activities and completeness of available data as specified and/or outlined by the established financial procedures and processes prior to being assigned to collection.
- Obtain information to secure appropriate payment of account by working with insurance companies, government agencies, other departments, providers' offices, attorneys' offices, patients and any other parties as necessary.
- Communicate all necessary requirements needed to support third party and government billing, including workers compensation.
- Perform data entry, maintain customer databases and document all calls. Assists customers with various patient account-related questions by telephone and through written correspondence. Completes adjustments, account notes, balance transfers, claim disposition and other necessary transaction to facilitate appropriate computer system activity.
- Completes all necessary research, account assignment, etc. for accounts assigned to collection agency; or necessary court documents for patient bankruptcies and probate.
- May perform skip tracing on patients with return mail; May perform insurance verification.; May be responsible to monitor and negotiate settlements with third parties.
- Perform other duties as assigned.
- College coursework in accounting, business, medical terminology, communication and social work preferred.
- Minimum of one year experience in collections, customer service, billing or related medical field preferred.
- Familiarity with government, commercial and third-party billing preferred.
- Proficient use of computers including MS Office applications
- Proficiency with 10-key calculators alphanumeric data entry skills are required
- Working knowledge of standard office equipment
- Strong communication skills, both verbal and written
- Ability to work both independently and interdependently with staff and team members with limited supervision
- Excellent problem solving and critical thinking skills
- Excellent customer service skills are required
SHARED SERVICES PHYSICAL / COGNITIVE REQUIREMENTS
- Work requires fairly light physical exertion from up to 65% of the time.
- Ability to lift objects weighing 30 lbs. or less.
- Work is performed under normal working conditions with adequate lighting and ventilation.
- Job duties frequently require intense concentration and attention to detail (up to 65% of work time).
See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.