NAPA Anesthesia Patient Financial Services Specialist I in United States
About This Location
Under direct supervision of the Patient Financial Services Manager, the Associate is responsible for effectively communicating with American Anesthesiology patients and external business partners to include MedData and Frost and Optima Collection Agencies. Associate will provide assistance with questions, account audits/research, insurance verification, account updates and claim submissions. Associate will work on weekly Accumulations of account to MedData. Associate will work various exclusion, exception and reconciliation reports associated with MedData workflows as well as work within the MedData Web Portal to resolve Info Requests. Associate will also work various IC System and Financial Corporation of America Collection Agency reports and provide customer service coverage for the Call Center as necessary.
Systems utilized will include the following: Medsuite, Collection Agency Portal, Master Database, MedData Web Portal, IVR, Accurint, MS Outlook, credit card processing software as well as MS Excel and Word. Position may require the use of specialized telephone equipment including digital displays, headsets and monitoring devices.
Duties & Responsibilities:
Provide excellent customer service to customers and external business partners (MedData and our Collections Agencies) using various forms and means of communication to appropriately respond to questions and inquiries.
1.a. Provide customers and external business partners with accurate information and account status. This requires thorough review of Medsuite and MedData Portal; review of account Notes; review of EOB’s and/or any other correspondence received and accurate assessment of new and/or revised information provided.
1.b. Request and validate the account information necessary for billing and claim submission.This may include primary and secondary insurance information, patient’s legal name, billing guarantor, current address and telephone number.
1.c. Make every effort to fully resolve issues at time of the inquiry. Escalation of accounts is appropriate only when Associate is unable to resolve issues. Refer to department guidelines for required actions.
1.d. Handle client complaints in a professional manner following all policies and procedures. In the event a patient/parent disputes the billed amount or validity of services, attempt a resolution; but if caller remains dissatisfied, advise of the right to file a formal, written billing dispute in accordance with policy/procedure.
1.f. Verify 3 separate elements of the patient account including the patient’s date of birth, prior to speaking with clients.
1.g. Elevate problems or trends to the department’s Management.
Ensure new and/or updated claims are submitted when appropriate to the insurance carriers.
2.a. Always validate patient’s legal name and secondary insurance information including dates of birth of the respective subscribers.
2.b. Verify patient eligibility by contacting payers, and accurately update all required fields in Medsuite for timely claim submission.
2.c. Always, correctly select apayer planthat represents the subscriber’s insurance and financial class.
Important: Payer Plan code selection must always reflect whether the insurance is contracted Managed Care, Commercial non-par, or Government, per MasterDatabaseContractsand/orPayer Search.
2.d. Determine whether a claim must be billed or re-billed to the primary or secondary insurance when appropriate.Decision points include (but are not limited to) whether the correct primary and/or secondary payers were previously billed, the status of outstanding primary or secondary claims, plan filing limits, small balance thresholds, etc.
2.e. Document all actions taken in appropriate Notes section of Medsuite or This includes but is not limited to: Calls received, outgoing calls made, accounts worked from web portal or reports, credit cards processed, etc. Accounts not noted are considered “not worked”.
Responsible for working MedData related tasks as follows:
3.a. Take appropriate actions to resolve various categories of MedData Info Requests found in the Web Portal within 72 hours. These include account research, notating web Portal and Medsuite/
3.b. Work Accumulation reports on a daily basis (a.k.a. scrubbing reports) to resolve any discrepancies prior to placement with MedData.
3.c. Work daily Exception Reports generated from MedData as instructed.
3.d. Perform analysis and work accounts generated from the 150 Day Reconciliation Report in order to reconcile Medsuite and MedData.
3.e. Work Front End Reconciliation Reports to ensure daily file transmissions are successful and prevent inconsistencies between both billing systems.
3.f. Work various MedData Queue Maintenance Reports and MedData follow up queue in Medsuite.
Coordination with IC Systems and Financial Corporation of America Collection Agencies.
4.a. Work various reports submitted by Collection Agencies and respond to inquiries in a timely manner. These include but are not limited to New Insurance Found, Debt Verification and Disputes.
Adhere to all policies and procedures.
5.a. Comply with all applicable policies and training documents including (but not limited to):Patient Accounts Training Manual,Patient Disputes,Customer Service Collection Methodology, andSecure Communication/PHI.
5.b. Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment.
5.c. Read and comply with all established policies and procedures, both internal and companywide, with special attention to Compliance policies.
5.d. Openly discuss weakness in policies and make suggestions for changes to benefit the company.
5.e. Maintain constant awareness of potential safety hazards ensuring necessary safety precautions.
Communicate effectively and professionally.
6.a. Communicate in an effective, business-like manner by telephone, e-mail, fax, and in the billing systems.
6.b. When speaking with clients, employ appropriate phone etiquette and technique including modulated tone and open, friendly demeanor.
7.a. Understand the importance of teamwork internal and external to the PFS Unit.
7.b. Work well with other co-workers (internal and companywide).
7.c. Willing to help other team members with problems as well as everyday tasks.
8.a. Able to perform daily tasks with little or no guidance.
8.b. Thoroughly troubleshoot problem accounts with limited direction from others.
Professional in demeanor and interpersonal relations.
9.a. Embody the principles of the corporate Mission Statement and Philosophy at all times.
9.b. Conduct all work relations on the tenets of professionalism, mutual respect and quality customer service.
Participate in quality improvement and morale building initiatives.
Meet or exceeds required departmental performance standards on a consistent basis.
Perform other job-related duties within the job scope as requested by
Work overtime in mandatory situations.
Minimal physical effort
Required lifting up to twenty pounds
Close vision, color vision, and ability to adjust focus are required.
Moderate noise level
Works in a clean, well-lighted and ventilated environment with no apparent exposure to physical hazards.
Associate's degree (A. A.) or equivalent from two-year College or technical school; or one to two years related experience and/or training; or equivalent combination of education and experience.
Ability to read, analyzes, and interprets general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to effectively present information and respond to questions from clients and the general public.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to calculate figures and amounts such as discounts and percentages.
Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to define problems collects data, establish facts, and draw valid conclusions.
About North American Partners in Anesthesia
North American Partners in Anesthesia (NAPA) has evolved through more than 30 years to become a leader in anesthesia and perioperative services. Single specialty and clinician led, we remain committed to our mission of delivering exceptional patient experiences, every day. At NAPA, we cultivate leaders, promote work-life balance, and celebrate diversity. We know your success promotes our success, and we give you the tools and programs to achieve your goals. With flexibility, a collegial and collaborative environment, a wide range of market-leading benefits, and career opportunities from coast-to-coast, your future is waiting at NAPA.
Wherever your career is today, let us take you to new heights. Take a LEAP to the destination of choice in anesthesia.
Job LocationsUS-Remote / Virtual
of Openings 1
Category Revenue Cycle