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Patient Accounts Clerk, Senior

Salary: $15.64-$19.09 hourly / $2,720-$3,320 monthly / Range: 4846

DEFINITION: Under general direction, leads the work of staff in the Patient Accounting unit, and acts as the supervisor of the unit in the absence of the Patient Accounting Supervisor; acts as technical resource to staff; computes, bills, posts, and collects patient accounts; and performs related duties as required.

DISTINGUISHING CHARACTERISTICS: This class is the lead worker in the Patient Accounts Clerk series. It is distinguished from the Patient Accounts Clerk by its responsibility for training staff and directing the workflow of the unit. The Patient Accounting Supervisor is distinguished from the Patient Accounts Clerk, Senior by the former's full supervisory responsibility over the Patient Accounting unit. Adequate performance at the Senior level requires providing leadership and technical expertise to staff, assisting the Patient Accounting Supervisor in recruiting, mentoring, and retaining Patient Account Clerks.

EXAMPLES OF DUTIES:

1. Acts as lead worker for Patient Accounting; assigns and reviews the work of subordinate staff; identifies training needs and provides needed training; coordinates daily activities of the Patient Accounting unit in order to provide adequate coverage of all essential functions; provides input for employee evaluations; assists Patient Accounting Supervisor in recruiting, mentoring, and retaining Patient Accounting staff.
2. Reviews plans, policies, and billing procedures for existing and new services and recommends changes to ensure maximization of revenues; reviews policies, procedures, and practices for compliance with established legal standards and state guidelines; ensures that the unit's work complies with standard departmental billing policies and procedures.
3. Provides liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, that a current record of all transactions is maintained, and that accounts are resolved; may act as liaison and technical expert for selected moderately-sized funding sources.
4. Verifies health care charges against established rates for diagnosis, treatment, services, and supplies; maintains patient accounts via an automated billing system, using standard industry codes to facilitate reimbursement from governmental and commercial insurers; and establishes pro-rata responsibility to permit prompt collection of patient's share.
5. Notifies or locates patients with delinquent accounts and attempts to secure payment; mails form letters to patients to encourage payment of delinquent accounts; confers with patients to determine reasons for delinquency, review services rendered, and establish payment guidelines.
6. Collects medical and patient data such as diagnosis, treatment, proof of eligibility, and insurance verification; submits claims to a wide variety of payment sources, including Medi-Cal, Medicare, and other third-party reimbursers; and prepares correspondence for collection of accounts.
7. May prepare general vouchers for transfer of funds from departments utilizing Public Health services, and for transfer of pharmaceutical and other products provided by Public Health; reviews Memoranda of Understanding of departments utilizing Public Health services and products in order to identify and distinguish chargeable and non-chargeable products and services.

EMPLOYMENT STANDARDS:

1. Two years of clerical experience with public contact, including one year performing medical billing, insurance, or related duties, preferably in a health facility; or,
2. one year of experience performing duties equivalent to Patient Accounts Clerk with Santa Barbara County; or,
3. A combination of training, education, and experience that is equivalent to one of the employment standards listed above and that provides the required knowledge and abilities.

Knowledge of: Current Procedures Codes (CPT) and International Class of Diseases Codes (ICD9) utilized in medical billing; fiscal record keeping using an automated system and/or health care billing including Medi-Cal, Medicare, or other third party reimbursers; public and private sources of assistance, and methods of qualifying for funding; collections laws, regulations, and techniques; medical terminology utilized in medical billing; current office practices and procedures; English usage, grammar, and spelling; basic math.

Ability to: identify training needs; plan, organize, assign, and prioritize the work of self and others; convince debtors of the necessity of assuming financial responsibility, and explain the financial impact of various alternatives; elicit and evaluate information, sometimes of a highly personal and sensitive nature from a broad spectrum of individuals and agencies; maintain confidentiality; read and apply policies and procedures to make appropriate decisions; work with minimal supervision and make independent decisions; prepare written correspondence; coordinate functions and work cooperatively with others; use and access database computer applications; explain processes and procedures to others.
 



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