POSITION GOAL

Protect the financial interests of the Clinic and its patients by thoroughly assessing any amounts owed on an account, arrangement of payment options and arrangement of all estimated patient responsibility portions of services rendered.

POSITION RESPONSIBILITIES

• In Athena, pull calendar of scheduled services for assigned Hughston Entity; identify accounts that meet Hughston pre-collection policy criteria.
• Utilizing tools such as Athena, Payer Website and/or Provider line; verify insurance benefits for physician/provider portion of surgical/in office procedures, MRI/Diagnostic Testing, and other services that require pre-collection.
• Utilizing provider/physician order and/or appointment notes, obtain anticipated CPT code(s) for anticipated services.
• Utilizing fee schedules within Athena and/or on payer website, obtain allowable amount(s) for anticipated CPT codes.
• Utilizing applicable benefits, anticipated CPT codes and allowable amount(s) obtained; complete estimate of out of pocket cost for services, on either Hughston Estimate Letter or Good Faith Estimate Template, based on insured or self-pay status.
• Contact patient via phone, e-mail and/or mail with estimated out of pocket; arrange for pre-payment of estimated out of pocket balances prior to surgical/in office procedures, MRI/Diagnostic Testing, and/or other services.
• As appropriate, address and collect payment for outstanding current balances.
• As appropriate, address outstanding collections balances and direct to Collections Agency for payment/payment plans. 
• Responsible for explanation of and adherence to pre-payment policies/options if patient is unable to make payment in full of estimated out of pocket costs.
• Responsible for explanation of and adherence to payment plan policies/options as well as executing payment plan within Hughston Billing system.
• Act as resource for clinic staff/ front desk regarding reimbursement methodologies, insurance plans, fee schedules and financial policies.
• Primary contact for face-to-face interactions with patient and/or responsible party for discussion of amounts in patient responsibility or estimated out of pocket.

POSITION REQUIREMENTS

Experience: One year experience in medical office setting required. Knowledge of medical insurance, medical terminology, and computer skills. Experience working with public.

Education: High School Diploma or GED required.

Special Qualifications: Must be able to work independently. Must have working knowledge of HIPAA

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.