Patient Accounts Rep a/r & Collections

Patient Accounts Rep A/R & Collections (Job ID: 9176)

The Accounts Receivable and Collections Department, which includes the cash office, is responsible for the timely billing and collection of revenues from government entities, insurance companies, other healthcare institutions, patients, and non-patients. The majority of payments are processed through the cash office, with the exception of the direct deposits from the Ministry of Health and LHIN for global funding.

The primary role of the Patient Account Representative (PAR) is to ensure that hospitalization charges incurred by patients at SMH are billed in a timely manner to the appropriate financially responsible agency. The role also includes liaising with Physicians and other Hospital units regarding rates and billing procedures as well as providing cost estimates.

Duties and Responsibilities

• Submits bill/invoices to payer by electronic data transfer or via postal service;
• Inputs manual charges to RCM (Revenue Cycle Management) as needed;
• Prints daily invoices and statements;
• Rebills/resubmits unpaid or rejected claims to payer if required;
• Collects all unpaid accounts assigned using the Aged Trial Balance;
• Documents all activities in RCM related to billing and collection of accounts;
• Obtains required information from Health Records, Physicians or other hospital units as needed;
• Answers phone query from patients related to billing and collection.
• First point of contact related to cost estimate enquiry from Physicians, Patients, Hospital Units, Law Office and Insurance companies;
• Explains to all Uninsured Patients about SMH billing and collection procedures;
• Obtains pre-payment on elective procedures not covered by OHIP or Insurance;
• Coordinates Health Record release to expedite payment of claims;
• Explains rates, billing and collection procedures to Uninsured Patients, Physicians and other Hospital Unit Staff
• Review and process accounts qualifying in the work queue;
• Obtain pertinent information missed during patient¿s registration process (e.g. health card, insurance coverage etc.);
• Correct errors by updating the ADT (Admission Discharge Transfer) System and ensures information is updated in Accounts Receivable System;
• Evaluates account in work queue according to billing rules set.
• Reverse charges due to duplication and other non-billable charges identified. This excludes adjustment of discounts and other write offs requiring approval from Management;
• Evaluates credit balances which include identification of refunds to patient, insurance or other hospitals;
• Obtains back up documents pertinent to refund and completion of refund request form for Manager¿s approval.
• Other duties as assigned

Qualifications

• Community College Diploma in Accounting or Business (2 year), or equivalent work experience;
• 5 years hospital/health care experience;
• 3 years accounts receivable and collections experience;
• Demonstrated proficiency with Microsoft Office Excel;
• Strong communication both in written and verbal;
• Excellent organizational skills and attention to detail;
• Excellent customer service skills;
• Ability to multi-task in a fast paced environment;
• Team player