财务评估员 患者会计
Financial Assessor Patient Accounting
财务评估员患者账务职责：
- 一致满足当前的生产率和质量标准，及时解决所有索赔编辑问题，报告待开票候选人，提交合规的外部索赔，临床文档要求以及与索赔相关的任何其他沟通（口头或书面），确保及时提交索赔，并保证索赔的完整、准确和无误。
- 一致满足或超过由患者账务主管财务评估员和运营协调员分配的生产率标准、目标、错误率和报告要求。
- 及时跟进和收取第三方付款人的应收账款。处理拒付和申诉的跟进工作，包括根本原因分析以减少/防止未来的拒付，同时努力推翻拒付以获得付款解决。
- 对第三方付款人就未结应收账款进行合规的跟进通信（如：对账单、信件、电子邮件、传真、门户邮件等）。
- 支持最优第三方应收账款的运营相关工作（如：管理护理、商业保险、医保、医疗补助、替代计划、工伤赔偿、公司账户、研究及特殊应收账款账户）。
- 每日系统性地审查工作列表，确保所有待处理账户已完成。
- 利用政府、商业和监管指南来追收未结应收账款。建议符合合同或行政核销条件的账户，并提供适当的理由和文件证明。
- 遵守HIPAA隐私标准，确保遵守患者健康信息的隐私实践。为实现部门应收账款目标的整体团队努力做出个人贡献。
- 识别客户、系统和流程改进的机会，并提交给管理层。
- 遵循NMHC的一般政策和程序、部门政策和程序以及任何应急准备程序。遵循联合委员会和其他外部监管机构规定的规则和程序。
- 在医院主机系统和报告软件应用中使用指定的菜单和路径，并向合适的主管报告软件应用问题。
- 使用
查看英文原文
The Financial Assessor Patient Accountingreflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
Responsibilities:
- Consistently meet the current productivity and quality standards in timely resolution of all claim edits, reporting of candidates for bill, outbound compliant claim submission, clinical documentation requirements and any other communication required (verbal or written) regarding claims ensuring timely filing of claims and clean, complete and accurate claims.
- Consistently meet or exceed productivity standards, targets, error ratios, and reporting requirements assigned by the Patient Accounting Lead Financial Assessor and Operations Coordinator.
- Timely follow-up and collection of third party payer receivables. Denials and Appeals follow-up including root cause analysis to reduce/prevent future denials while working to overturn denials for payment resolution.
- Compliant follow-up correspondence to third party payers regarding outstanding accounts receivables (i.e. Statements, letters, e-mails, faxes, portal mail, etc.).
- Support the operations related to optimum third party accounts receivables (i.e. Managed Care, Commercial, Medicare, Medicaid, Replacement plans, Workers Compensations, Corporate Accounts, Research, and Specialty AR Accounts).
- Perform daily, systematic reviews of work lists to ensure all accounts already to be worked are completed.
- Utilize Government, Commercial, and regulatory guidelines for collection of outstanding accounts. Recommend accounts for contractual or administrative write-off and provide appropriate justification and documentation.
- Practice HIPAA privacy standards and ensure compliance with patient health information privacy practices. Provide individual contribution to the overall team effort of achieving the department accounts receivable goals.
- Identify opportunities for customer, system and process improvement and submit to management.
- Follow the NMHC general Policy and Procedures, the Departmental Policy and Procedures, and any Emergency Preparedness Procedures. Follow Joint Commission and outside regulatory agencies mandated rules and procedures.
- Utilize assigned menus and pathways in the hospital mainframe system and report software application problems to the appropriate supervisor.
- Utilize assigned menus and pathways in external software applications and report software application problems to the appropriate supervisor.
- Utilize assigned computer hardware and report hardware problems to the appropriate supervisor.
- Participate in the testing for assigned software applications, including verification of field integrity.
- Assist the Patient Accounting Operational Coordinator and Patient Accounting Team Lead Financial Assessor with special projects and other duties as assigned, as necessary.
- Attend training and seminars as assigned and approved by the Patient Accounting Operations Coordinator.
Additional Responsibilities:
- Demonstrate excellent customer service through oral and written communication in providing assistance/expertise to patients, authorized guarantors, and other external and internal contacts.
- Demonstrate proficient use of systems and execution of processes in all areas of responsibilities.
- Working knowledge of physician and facility billing and follow-up including understanding of insurance rules and regulations especially Medicare and Medicaid. Knowledge of HIPAA standards.
- Ability to perform mathematical calculations.
- Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices. Basic knowledge of medical terminology and billing practices
Required:
- High School diploma
- One year related work experience or college degree
- Ability to perform mathematical calculations
- Basic knowledge of medical terminology and billing practices
- Extensive experience and knowledge of PC applications, including Microsoft Office and Excel
- Learn quickly and meet continuous timelines
- Exhibit behaviors consistent with principles of excellent service.
Preferred:
- Two or more years’ college or college degree.
- Call center, telephone work experience or cash collections experience.
- Knowledge of Epic Systems.
- Two (2) years progressive work experience in a hospital/ physician billing or SBO environment.
- Detail-oriented, good organizational skills, and ability to be self-directed.
- Strong time management skills, managing multiple priorities and a heavy workload in a high-stress atmosphere.
- Flexibility to perform other tasks as needed in an active work environment with changing work needs.
- High-level problem solving, analytical, and investigational skills.
- Excellent internal/external customer service skills.
Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.
Background Check
Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act.
Artificial Intelligence Disclosure
Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.
Benefits
We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events.
Click on or copy and paste URL to your browser to view detailed benefits information
NorthwesternMedicine Career Page
Please refer to the Benefits Eligibility by Employment Classification to determine benefits eligibility for job postings.
If sign-on bonus is included in a job posting eligibility is as followed: Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign-on bonus. Exception: New graduate internal employees seeking their first licensed clinical position as a Registered Nurse at NM may be eligible.
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better?
Originally posted on Himalayas