Patient Account Associate

General Description of the Job Class: Record and generate a variety of information pertaining to the patient revenue process associated with Financial Assistance Policies. This accuracy-driven, high-performance level position requires a certain degree of knowledge of complex rules and a corresponding ability to apply these rules in the work environment to achieve desired outcomes.

Workflow associated with Financial Assistance Applications (75%):

· Answer and resolve all inbound inquiries and issues regarding financial assistance support for Duke patients.

· Identify professionally on all calls, inquiries and inventory aligning to all Duke branding and Self-Pay, Call Center/MyChart expectations

· Analyze and complete all Financial Assistance Applications that are presented by collecting information and data, conducting thorough research of the EPIC patient accounting systems, Hyland OnBase for documents that may have been imaged (EOBs, historical statements, admitting documentation, patient correspondence, etc.), as well as RTE and payer portals for insurance eligibility when necessary. Analyze information for an appropriate solution and take the necessary actions needed to resolve the inventory timely and accurately.

· Follow through on all customer issues promptly and accurately, seeing through to completion.

· Thoroughly update and document notes/system comment fields with all information pertaining to all inventory workflow streams (i.e. questions, answers, actions, follow-up items required).

· Communicate with the patient, physicians, collection agency, internal departments and all other internal and external customers in a professional, courteous, and respectful manner.

· Post adjustments when supported by policy; contractual/pro-rated uninsured discounts and other adjustments as necessary, following appropriate policy guidelines.

· Provide financial counseling to patients, guarantors, and attorneys regarding charges for health care services. Validate that charges are correct and request medical review and audit when/if

necessary.

· Discuss and establish payment plans for patients that require terms to pay off a balance or guide patient through financial assistance options.

· Maintain a working knowledge of relevant payer billing requirements, Self-Pay workflows, MyChart functions and reimbursement regulations.

· Follow escalation protocols where applicable to ensure appropriate and timely resolution of all patient inquiries.

· Proactively report trends and system-related issues to management in a proactive & timely manner.

· Meet and maintain quality, production and behavioral standards as documented in the onboarding documentation as well as monthly validation reviews.

· Adhere to DUHS badge swiping/clocking and time/attendance policies.

· Work pending inventory in a first in-first out manner and maintain appropriate inventory levels as instructed by management.

· Participate in committee meetings across our entity as it relates to accounts receivable and/or financial data operation improvements, as necessary.

· Produce itemized statements and financial assistance determination letters and mail to patients, as applicable to health-system financial assistance policy standards.

· Assist patients that are requesting financial assistance by conducting an initial screening and sending that patient a copy of the application when requested. Provide regular and timely feedback regarding processing status of the application(s).

· Follow departmental policies necessary for charge corrections, transferring credits, coding changes, service/charge disputes, and locating payments.

· Follow appropriate policy, update all system information to accessible fields to include correct registration information, address, telephone numbers, guarantor information, employer information, insurance information, etc.

Workflow Associated with Estates (20%):

· Review aged statement holds for release and resolution as they arise.

· Answer and resolve all inbound inquiries and inventory via workflows for Estates in timely and accurate manner.

· Analyze and complete all Estate applications (to include amended claims) and follow-up workflows that are presented by collecting information and data accurately as well as conducting thorough research via all workflow and system outlets mentioned previously herein.

· Resolve data element errors returned from our Estate vendor (DCM) within EPIC work queues and return to DCM’s dedicated attention for resubmission when necessary.

· Review and submit settlement requests for approval to Self-Pay management and send letters of satisfaction through Probate Finder accordingly.

· Provide information regarding deceased patients to the surviving spouse, courts as well as attorneys (where appropriately applicable) pertaining to charges for health care services. Validate that charges are correct and request medical review and audit as necessary.

Other (5%):

· Contribute to a positive working environment and perform other duties as assigned/directed

to enhance overall efforts and demonstrate the explicit values of Duke Health.

· Adhere to all HIPAA and confidentiality guidelines.

· Perform other related duties incidental to the work described herein.

· Engage in frequent rounding conversations with all leadership personnel.

· Complete all safety training prior to yearly renewal date/month.

· Comply with required on-line safety training via the Learning Management System (LMS).

· Work as a team member towards common goals.

· Adhere to a schedule to ensure availability and demonstrate flexibility to accommodate immediate staffing needs.

· Develop and maintain a working knowledge of all Maestro Care and ancillary systems utilized by your immediate team.

· Develop and maintain working and proficient knowledge of personal computer software required for fulfilling role responsibilities, including: EPIC, Excel, Microsoft Word, & others.

Required Qualifications at this Level:

Education

This work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some post-secondary education preferred. Additional training or working knowledge of related business processes is further preferred.

Experience

Two years’ experience working in hospital access environments, physician office or billing and collections or an equivalent combination of relevant education and/or experience.

Degrees, Licensure and/or Certification