Medical Billing Specialist jobs in Petaluma, CA

Overview

The Financial Counselor provides assistance to patients with Hospital Presumptive Eligibility (HPE) and Charity Care applications; may act as a liaison between the patient and Patient Advocate Vendor to obtain MediCal. Works though patient's financial obligations, both with and without insurance, and provides assistance with payment arrangements. Responsible for the collection and follow-up of accounts with patient liability in accordance with collection guidelines and facilitates the timely receipt of patient liabilities for hospital services. Evaluates incoming patient calls, visits or correspondence and answers questions, resolves issues and assists with payment arrangements for traditional Self-pay and/or patient balance after insurance; prepares accounts for bad debt write off. Provides assistance to vendor on special requests for payment arrangements, settlements offers, and monitors placement Bad Debt accounts. Escalates urgent financial issues to manager as necessary. Manage and monitor patient accounts uploaded to 3rd party vendors and completes billing record requests. Works independently with a moderate level of supervision.

Responsibilities

Maintains current knowledge of all financial assistance programs including HPE and Charity Care; provides education/guidance to patients needing to apply for Financial Assistance and provides assistance with completing the required application process. Updates Federal Poverty Level yearly on Charity Care Application. 

Maintains Patient Advocate vendor data (i.e., MedData) on all active, pending, denied, and/or approved cases, and provides all requested documentation in a timely manner. Provides education/guidance to patients needing to apply for Medi-cal or other Government programs.

Assist patients with billing and/or insurance questions, returning calls on a regular/daily basis; resolves complaints and concerns about charges; records patient complaints in electronic compliance reporting system (i.e., MIDAS) in a timely manner.

Facilitates the timely receipt of patient liabilities for hospital services by contacting patients directly. Verifies and updates demographic and/or insurance information and generates itemized bills for patients as requested. If insurance is obtained, submits claims to appropriate insurance company(s). 

Establishes payment arrangements according to the Sonoma Valley Hospital's policy and processes credit/debit card payments on a daily basis; conducts telephone collections based on queue of self-pay accounts; processes bad debts; issues patient refunds, as appropriate; and receives and process Bankruptcy Notices for hosptial, updates accounts accordingly to zero out debt and reports to collection angency.

Provides assistance to vendor on special requests for demographics, payment arrangements, settlements offers, and monitors placement of Bad Debt accounts.  

Manage and monitor patient accounts uploaded to 3rd party vendors and completes billing record requests. Escalates urgent financial issues to manager as necessary.  Process Mail Returns Daily 

Provides a variety of other clerical duites as needed, such as opening and sorting hospital mail for each department and scanning financial documents into the EHR system. 

Qualifications

Education: High School diploma or equivalency; some college preferred.Experience: Minimum two (2) years of collection experience in a healthcare setting, preferably acute care hospital or physician's office with high-call volume.  Fluent in both Spanish and English is required.Licenses & Certifications: Current certification in Hospital Presumptive Eligibility; or obtained within first ninety (90) days.Required Skills & Knowledge: Excellent customer service skills, excellent written and verbal communication skills, strong interpersonal skills, and excellent organizational skills. Must be able to disseminate complicated billing data/information in an easy-to-understand manner and provide clear explanations/instructions to patients. Demonstrated ability to curteously listen to patients who are frustrated with their charges/bills, demonstrate empathy and compassion and provide information/options to help them manage their situation in a calm and professional manner. Able to coordinate multiple tasks and appropriately manage priorities. Able to professionally manage high-call volume; able to sit for long periods of time. Proficient in Microsoft Office; knowledge of medical terminology a plus; must be bilingual in Spanish.  

Compensation

Minimum:

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