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Full/Part Time: Full Time
Location/Affiliates: The Mount Sinai Hospital
Department: 518 - Credit
Requisition Number: 13-1569304
Under the supervision of the Patient Financial Supervisor/Manager, performs a variety of patient accounting functions, including but not limited to financial verifications, preparation of Medicaid applications, billing, processing accounts, payment and/or charge posting, account resolution, follow-up collections (Third party and patient), correspondence/mail distribution, vender account reconciliations and customer services questions.
Adheres to the Stratified Process Work Environment utilizing either the On-Trac or Trac system applications.
Analyzes accounts to resolve issues that result in billing and/or payment delays.
Prepares schedules on work findings, cash postings, global arrangements (splits) and all other schedule that is assigned.
Prepares all downloads of billing files from Mainframe System to Clearing House. Transmits all clean claims daily to Clearing House and other direct payers.
Bills and follows-up on specific specialized accounts receivable.
Interviews potential Medicaid patients before admission, during admission and after discharge of admission to obtain essential documentation to process Medicaid application, financial assistance and/or determine the method of hospital reimbursement. Utilizes and inputs into Medicaid Tracking System (MEMS) when preparation of Medicaid application is determined.
Collects form of payment(s) (deposits), for elective, maternity, international, deductible/co-insurance/co-pay and any other patient responsibility. This collection can be prior admission, during admission and/or after admission.
Obtains and validates patient's third party health insurance. Coordinates and prioritizes insurance within PFS Systems when more than one (1) valid insurance exists. Validation of third party insurance is obtained via various eligibility systems, calls to third party carriers and/or patients.
Edits unbilled/unprocessed accounts (billing) using PFS HIS Systems, Clearing House Claim Scrubber and/or any payer websites available for claim correction of billed accounts.
Bills claims to third party payers either electronically or manually.
Corrects denials and re-bills accounts through PFS Systems.
Posts all manual charges into the patient accounts system. Inputs appropriate data elements into PFS Systems for specific charge codes (value codes, condition codes, etc).
Posts payments (manual and electronic kick-outs). Posts adjustments and reconcile/disposition accounts when necessary.
Reconciles payments on accounts to ensure that payments agree with negotiated rates. Reviews listings of accounts to ensure payments are received when there are rate changes and/or annual rate increase within said contracts.
Follows-up on all billed third party/self-pay accounts. These accounts are followed up based on parameters set within area of assignment and can be different based on payer. Examples: rebilling of account, transfer, assignment of different and/or correction of insurance data, account resolution, phone call, and inquiry through third part website or call to patient.
Distributes and sorts departmental mail received.
Notes correspondence on individual patient accounts. Correspondence is worked within PFS Systems based on the parameters set within the department all other is distributed to appropriate work area.
Requests Medical Records and communicates correspondence with inter-office departments.
Sends bills to patients for self-pay balances.
Responds to patient calls or written correspondence regarding billing issues. Proper customer service techniques should be used.
Scans documents of assignment.
Reconciles vender accounts. Work payment remittance and closed report/files received by outside venders.
Prepares patient and third party refunds.
Responds to third party audits.
Account resolution performed on accounts with credit and debit balances.
Performs other related duties as required.
Attends Workshops, weekly unit meets and any other meeting assigned.
Ensures timely completion of required work assignments.
High School Diploma, College preferred.
1-2 year's previous PFS Hospital experience preferred
Typing skills of a minimum of 35 - 40 words per minute, and good data entry skills.
Knowledge of Patient Accounts System(s): Eagle, MEMS, Trac/On-Trac, Cirius, FSS, Cerner, and various Insurance Websites preferred.
Knowledge of Microsoft Excel and Word.
Excellent written and oral communication skills.
Mount Sinai Medical Center is an equal opportunity/affirmative action employer. We recognize the power and importance of a diverse employee population and strongly encourage applicants with various experiences and backgrounds. Mount Sinai Medical Center--An EEO/AA-D/V Employer.