About the position
CBO Collection Financial Analyst perform various interviewing, fact collection and financial evaluation tasks in connection with credit and collection in a large and diversified hospital serving both non-indigent and indigent patients qualifying for various types of specialized assistance programs. Incumbents may specialize in either credit or collection work or a combination of both. Primary emphasis is on financial counseling with patient from pre-admission through account becoming a discharged zero balance. Incumbents are responsible for interview of patient, family or guarantor to explain charges, hospital policy and payment procedures. The incumbents are also responsible for confirming all commercial insurance and conducting extensive third party and welfare program finding in order to obtain payments as promptly as possible or direct account to collection agency.
Responsibilities
- Identify and resolve accounts and patient concerns through the use of JHS Patient Accounting Systems.
- Adjudicate patient accounts as appropriate based on dollar threshold and obtain the appropriate approval.
- Analyze patient account balances and submit adjustment or payment transfers to the appropriate management approval.
- Update JHS Patient Accounting Systems with any changes that may be necessary to accurately reflect the patients demographic and financial information.
- Determine if payments are accurate based on the Payer agreement.
- Understand a variety of payment mechanism from DRGs, Stop Gap, Percent of Charge, Per Diem and/or any other special agreements.
- Contact Payers and Debtors to ensure timely payment and account resolution.
- Research, resolve delinquent accounts and document all follow up activity.
- Validate and determine if all data on account is accurate to conduct appropriate follow-up activity.
- Use daily work list or other appropriate account listing to determine accounts that need to be worked each day.
- Work with supervision and management to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department.
- Identify trends of denials or other payer issues and report those issues to the management team.
- Quickly respond to changes in the Payer requirements and regulations to improve collections.
- Maintain productivity and quality standards in accordance with department policy and procedure.
- Continually improve knowledge of Medicare, Medicaid, and other third party Payers.
- Work directly with other departments and physicians that may provide information on collecting JHS account receivable.
- Develop and maintain good working relationships with others that impact the collection of JHS receivables.
- Insure proper use of all information systems available within the Hospital technology platform.
- Comply with HIPPA and JHS requirements as it relates to Patient Health Information.
- Adhere to JHS and Departmental policies and complete annual testing as may be required.
- Attend mandatory training and maintain proficiency with the ability to pass job related skills tests with 85%.
- Demonstrate behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
- Perform other job duties that may be required to provide the quality and level of service expected by JHS and Revenue Cycle management.
Requirements
- Generally requires 3 to 5 years of related experience.
- High school diploma is required.
- Bachelor's degree in related field is strongly preferred.
