Patient Collections Specialist - St. Petersburg, FL

Patient Collections Specialist

Florida Pediatric Associates is seeking an experienced Patient Collection Specialist to join the team.

Top benefits package includes:

• Hybrid work: Employee will be able to work 4 days from home and 1 from the office.
• 100% Employer Paid Employee Medical
• Dental
• Vision
• 100% Employer Paid STD & LTD
• Supplemental Insurance Options
• 7 Paid Holidays
• 401k Plan and Amazing Work Environment

Qualifications:

Education:

1. High School diploma or equivalent.
2. Certification in medical coding (CPC) preferred.
3. Working knowledge of Medicare and Florida Medicaid coding rules and regulations including but not limited to as National Correct Coding Initiative edits and payer guidelines.
4. Working knowledge of the current International Classification of Diseases (ICD), Current Procedural Technology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding and terminology.

Experience:

1. Two or more years of medical claims collection/accounts receivable management experience including patient (self-pay), commercial and government payer classes.
2. ICD, CPT and HCPCS coding experience.

Principal Duties and Responsibilities:
Specific:

1. Strictly adhere to Department Policies, Procedures and Protocols, especially those that apply to medical claims collection duties and processes.
2. Strictly adhere to the Company Compliance Program and immediately report suspected acts of non-compliance to the Department Director or designee.
3. Strictly adhere to the Company Privacy and Security Standards and immediately report suspected breaches to the Department Director or designee.
4. Strictly adhere to the Department Quality Improvement and Assurance Program and immediately report deviations from quality metrics to Department Director or designee.
5. Review all patient accounts with outstanding balances and perform necessary collection procedures for Self-Pay accounts receivable per the Department Policies & Procedures.
6. Process patient statements tasks to generate weekly patient statements.
7. Print and mail delinquent account collection letters per Department Policies and Procedures.
8. Respond to queries regarding patient account balances.
9. Respond to information requests from collection and/or collection agency regarding patient account balances.
10. Contact patients/guarantors regarding outstanding account balances.
11. Process patient payments.
12. Initiate patient refunds per Department Policies & Procedures.
13. Review and implement payment plans for outstanding account balances in the Practice Management (PM) system.
14. Verify patient insurance coverage and eligibility and submit to payer for claims processing.
15. Review patient account balance for accuracy and rebill claims to insurance if needed.
16. Process returned mail and update patient addresses in the PM system.
17. Distribute scheduled patient account balance reports to Client Practices.
18. Document all collection efforts in the PM system.
19. Promptly report unsuccessful collection efforts and collection problems to Department Director or designee.
20. Promptly report matters that delay or disrupt workflow to the Department Director or designee.
21. Promptly notify the Department Director or designee of patient collection trends.
22. Monitor and report any patient collection issues to the Department Director or designee.
23. Promptly report coding-related issues to the Department Director or designee.
24. Promptly report unsuccessful collection efforts and collection problems to Department Director or designee.
25. Promptly notify the Department Director or designee for trends identified pertaining to denials and when the volume of denials for a particular CPT code appears excessive
26. Monitor and report any payer related claims issues to the Department Director or designee.
27. Promptly report matters that delay or disrupt workflow to the Department Director or designee.
28. Perform other duties as assigned.

General:

• Serve as brand representative for FPA by embracing the Company culture and mission statement, core values and standards of conduct.
• Strictly adhere to all Standards.
• Compliance Standards.
• Privacy and Security Standards.
• Workplace Standards.
• Workforce Standards.
• Strictly adhere to Department policies and procedures.
• Participate in quality assurance and quality improvement process.
• Participate in corporate compliance program.
• Promptly report suspected acts of non-compliance with Company Standards and Policies.
• Participate in job-related continuing education programs.
• Perform other duties as assigned by your supervisor or designee.

EEOC Disclaimer:
FPA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression. In addition to federal law requirements, FPA complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.