Patient Account Specialist

Job Title: Department: Reports To:

Patient Account Specialist Revenue Cycle Management Revenue Cycle Director

Employment Status: Salary (Exempt)

Salary Range: $40k-$50k annually

MISSION STATEMENT: Leading adolescents to a new legacy.

The mission of CLEARFORK ACADEMY is to offer the highest quality and professional, substance abuse and mental health treatment across a full continuum of care.

We are committed to treating patients and their families with the highest regard and respect as clients work toward reaching their highest growth potential in their recovery process. This is accomplished through the strict adherence to the highest ethical standards of care and policies and procedures set forth by the Texas Department of State of Health Services and the Joint Commission.

•  CLEARFORK ACADEMY ensures all clients are treated with compassion, respect, and dignity regardless of race, creed, age, sex, handicaps, or sexual orientation.

•  CLEARFORK ACADEMY employees are competent and responsible personnel who adhere to a strict code of professional ethics which includes but is not limited to the prohibition of fraternization with patients, exploitation of clients, or any criminal behaviors.

•  CLEARFORK ACADEMY provides clients with accurate and complete information regarding the available services including the program rules, regulations, goals and objectives of the program.

•  Appropriate availability of alternative treatment modalities is made at any time before, during or after treatment if they are requested or the client's needs are out of the scope of our practice.

•  CLEARFORK ACADEMY will ensure that discharge from treatment is conducted in accordance with Texas rule standards.

•  CLEARFORK ACADEMY provides both Texas and Joint Commission environment of care standards.

•  CLEAR FORK ACADEMY will take all necessary and appropriate measures to maintain individual client records and information in a confidential and professional manner.

•  CLEARFORK ACADEMY strives to maintain positive relations with the surrounding community and pursues every reasonable action to encourage responsible client behaviors and community safety.

SUMMARY

The Patient Account Specialist will be responsible for the oversight and support of their assigned team in addition to maintain their daily workload for addressing patient balances (current & past due), responding in a timely manner as defined by department guidelines to patient inquiries. They will maintain a professional and calm demeanor when contacting patients. They will effectively communicate information to patients, both written and verbally. They process and collect patient balances owed as well as work with patients on setting up and maintaining payment plans if applicable to patients. They will work in collaboration with other teams within the department as needed for certain accounts assigned.

AGE/PATIENT POPULATION(S) SERVED

Age of Patient Population Served: Adolescent and Young Adult Males/Females

Population Served: Persons meeting DSM 5 criteria for substance use disorders with or without co-occurring psychiatric illness.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Ensure KPl's established by leadership are being met daily, weekly, & monthly.

1. Collect payment for services rendered.

1. Arrange balance repayment, establish payment plans and tend to the collection of payment plans on a day-to-day basis.

1. Communicate patient balances to the patient or legal guardian by phone or e-mail to solicit payment.

1. Answer patient questions regarding copayments or problems with their account.

1. Understand insurance VOBs, EOBs, and claims on patient accounts.

1. Effectively communicate with external departments to help address patient balances as needed.

1. Assist the billing office with calling patients to gather information as needed related to claims or payments.

1. Update the patients EMR chart with the correct insurance and subscriber information before the patient's chart is pushed into CollabMD

1. Return phone calls and emails within 24 hours

1. Maintain patient confidentiality and function within the guidelines of HIPAA.

1. Stay current with working the unapplied and credit balances.

1. Work refund requests from patients ensuring they are legitimate before sending all documentation to the Revenue Cycle Manager to review for approval.

1. Attend department & team meetings to report the status on notable accounts and/or projects.

1. Special projects as assigned, if needed and perform other related duties as assigned.

MINIMUM JOB REQUIREMENTS

Education: Minimum high school diploma or GED. Preferred associate degree in healthcare management, business management, or related field.

Experience: A minimum of 1 years' experience a healthcare facility and/or office, preferably in a billing/coding role. Preferred 2 years' experience.

Certification: Preferred but not required - Certified Professional Coder, Certified Professional Biller, Certified Outpatient Coder, or Certified Coding Associate/Assistant.

Additional Requirements: A working knowledge of the DSM-V, ICD-9 and ICD-10, CPT (Current Procedural Terminology), and HCPCS (Healthcare Common Procedure Coding System) codes, revenue codes and denial codes.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

1. Work effectively and efficiently in an independent role.

1. Ability to remain calm while working efficiently under stressful conditions.

1. Must have excellent interpersonal communication skills, to include written and verbal, to effectively communicate within the organization and outside vendors, and patients.

1. Ability to work out of multiple systems.

1. Ability to accurately understand various aspects of the billing process.

1. Working knowledge of billing system in identified electronic health record system.

1. Knowledge of forms used to submit claims to third-party payers: UBO4, CMS 1500

PHYSICAL DEMANDS/WORKING CONDITIONS:

1. Ability to sit for extended periods of time 8-10 hours).

1. Ability to reach above and below the waist, turn, twist and to manipulate small tools (copier, computer, telephone, typewriter, calculator, safe, facsimile machine).

1. Ability to see well enough to read handwritten and typewritten material.

1. Ability to stand and walk the facility grounds.

1. Ability to spend 10% of working time outside in temperatures varying from -0° F. to 110° F.

1. Ability to travel between facility locations, and at times, the corporate office.

1. Ability to handle multiple projects and tasks under deadlines and with short notice.

EEOC STATEMENT:

It is our policy to abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-l.4(a), 60-300.S(a) and 60-741.S(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.