Job Information
Sheridan Memorial Hospital Patient Account Representative in Sheridan, Wyoming
ABOUT SHERIDAN MEMORIAL HOSPITAL At Sheridan Memorial Hospital, we are proud to be ranked in the top 13.6% of hospitals rated by the Centers for Medicare and Medicaid Services. We believe that our ability to deliver excellent healthcare begins with our people, and we are proud of our more than 850 skilled, experienced, and caring employees. We have over 100 providers who specialize in 25 areas of expertise. Our facility is state-of-the-art, and we are dedicated to providing outstanding patient-centered care. ยท Nestled at the foothills of the Big Horn Mountains in northern Wyoming, spectacular scenery and outdoor activities abound. Our hospital has the latest technology and equipment comparative to that of many larger facilities, and you will find our staff is friendly, compassionate, caring, and courteous. We focus on creating and nurturing a workplace that encourages, recognizes, and rewards individual effort and creativity. Leadership is responsive to changing modes of healthcare delivery and adapts accordingly. We value effective communication and honesty and believe teamwork based on mutual respect is key to success.
JOB SUMMARY
Responsible for compiling itemized bills, verifying patient insurance coverage and computing patient insurance benefits. Works closely with the Case Manager, Green House Living management, Third Party Billing Company and outside Vendors. Oversee the Resident Trust Fund including deposits and Charges. Participates in Performance Improvement activities.
ESSENTIAL JOB FUNCTIONS
Creates new processes for A/R, Resident Trust, Deposits, and statements.
Validates there are internal controls in place throughout the Accounts Receivable Process
Oversees the Petty Cash Process and validates the balances are maintained accurately
Verifies accurate resident information by reviewing accounts in Point, Click, Care, making necessary corrections to ensure timely claim submission.
Monitors all claims in Point, Click, Care & Medicaid / Medicare - correcting as need to insure claim submission and reimbursement. Contact residents when additional information is required to file a claim or when Medicaid or Medicare has requested additional information.
Stays informed about changes in Medicare and Medicaid, and other third party payers.
Processes correspondence and Explanation of Benefits in a timely manner.
Processes overpayment refunds as required.
Remains current on Medication, Therapy, Salon Services and other third party payers for billing functions.
Stays current on Residents balances in Point, Click, Care. Follows policy steps for Residents with large balances. Notifies Management with issues.
Understands Resident Trust Fund guidelines and maintains account balances in Point, Click Care and validates balance aligns with the funds in Bank Account.
Sends out monthly statements timely and on schedule for Resident Accounts and Resident Trust Fund Accounts.
Demonstrates the ability to be flexible, organized and function well in stressful situations.
Interact with residents/families in a professional manner. Provides explanations regarding statements and coverage.
Treats residents/families with respect; ensures confidentiality of residents' records.
Maintains a good working relationship within the department and with other departments.
Maintains a professional working relationship with Third Party Vendors and Medicaid.
Performs other duties as assigned.
Ensures documentation meets standards and policies.
POSITION QUALIFICATIONS Education / Experience / License and Certifications
High School Diploma or general equivalency diploma (GED).
Recent experience in long-term care or billing preferred
Additional Skills
Able to communicate effectively in English, both verbally and in writing.
Basic computer knowledge, data entry skills
Thorough understanding of Medicare, Medicaid, HMO's, PPO's, private insurance companies.
Highly developed organizational skills.
Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products.
Pre-employment drug and alcohol screening is required.
Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to race, color, religion, age, sex, national origin, disability or protected veteran status. If you would like more information about your EEO rights as an applicant under the law, please click here (http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf) .