Reporting to the EHR/Patient Accounts Administrator and the Chief Operating Officer, the Patient Accounts Specialist is responsible for processing Medicare, MaineCare and Commercial Insurance, Agency, PNMI, Self-Pay, Grant billing, payments and denials. This position requires overall knowledge of patient accounts, data entry/keying and billing/receiving functions.
ESSENTIAL JOB FUNCTIONS:
· Demonstrates commitment to the mission of the agency with a strong understanding and respect for the goals of agency activities.
· Responsible for billing Medicare, MaineCare, Commercial Insurance, Clients and other entities in accordance with established procedures.
· Receives and processes insurance payments, denials and refunds.
· Receives and responds to correspondence from clients regarding billing issues and assists them with any concerns or questions regarding their bills.
· Actively works aged accounts receivables.
· Monitors client payment agreements and provides follow-up as necessary.
· Communicates with Clinical Team Lead and/or Program Manager on delinquent, active accounts over 90 days.
· Sends information to designated Collection Agency on appropriate client accounts. Monitors payments from Collection Agency.
· Provides the EHR/Patient Accounts Administrator and the Chief Operating Officer with information on accounts needing to be written off.
· Processes specialized billing for: Private Non-Medical Institutions (PNMI), Spend-Downs, and Veteran's Behavioral Health Homes (BHH).
· Cross-trained to provide back-up for other positions within the Patient Accounts department.
· Completes end of month balancing.
· Functions in a cost effective manner with regard to the utilization of time, mileage, phoning, supplies, equipment, meetings, etc.
· Participates in scheduled meetings, supervisory sessions, staff meetings, and other inter-agency and intra-agency meetings as appropriate for program and position.
· Seeks additional consultation and/or supervision when needed and as appropriate.
· Promotes a positive agency image to staff and community.
· Ensures client confidentiality is maintained at all times and in accordance with federal, state, and agency standards.
· Completes and submits accurate time sheets according to policies and procedures.
· Participates in training to maintain or enhance job skills.
· Adheres to agency Risk and Safety policies and procedures.
· Adheres to organizational standards for performance (see attached).
· Performs other related duties, as requested.
High school diploma or equivalent with prior work experience in billing Medicare, MaineCare and Commercial Insurance.
General knowledge of billing regulations in Medicare, MaineCare, and Commercial Insurances.
Thorough knowledge of current office
practices, procedures, and equipment, including
the use of computers.
Knowledge of computer software programs, Word, Excel and Outlook.
Ability to work independently, handle multiple tasks, and meet project deadlines with a high degree of accuracy.
Strong organizational skills.
Ability to perform mathematical computations quickly and accurately.
Ability to communicate effectively both verbally and in writing to establish effective working relationships with other agency personnel.
The above statements are intended to describe the general nature and level of work being performed by people assigned to do this job. The above is not intended to be an exhaustive list of all responsibilities and duties required. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position.
Tri-County Mental Health Services is proud to be an Equal Opportunity Employer and is committed to maintaining a culture of mutual respect. We do not discriminate against any employee or applicant for employment because of race, color, religious creed, sex, national origin, ancestry, age, physical or mental disability, sexual orientation, gender orientation, or expression. We celebrate our differences and thrive on inclusivity.