Patient Financial Specialist

Company Overview

Spectrum Healthcare Partners is Maine’s largest multi-specialty, physician-owned and directed professional organization and is comprised of over 200 physicians practicing in the areas of anesthesiology, orthopaedics, pain management, pathology, radiation oncology, radiology, and vascular & interventional services. Spectrum provides services at many of Maine’s hospitals throughout the state and in eastern New Hampshire.

POSITION SUMMARY

ESSENTIAL FUNCTIONS

1. Primary contact for patients and staff regarding collection of private pay/self-pay financial responsibilities for services received.
2. Active member of pre-services collection efforts to collect private/self-pay balances before or on date of service. Accurately calculates and collects payments for uninsured patients and patients with a high deductible plan before services are rendered.  Works with customer/patient to secure elective procedure balances/deposits prior to service.
3. Responsible for financially clearing uninsured patients, and patients with bad debt balances for new episodes of services.
4. Works and monitors self-pay held accounts to ensure proper and timely disposition.
5. Manages inquiries and calls for price estimates for services including surgeries.  Ensures calls are responded to within 2 business days.
6. Serves as customer service resource for internal and external customers, patients, etc. Answers calls from patients/internal and external customers and makes calls to ensure timely collection of self-pay balances.  
7. Works with others to ensure time of service collection and co-pays are collected promptly.  Provides resources, training and guidance to practice staff on time of service collection workflows and expectations.  Ensures time of service collection of co-payments is at or above established goals.  
8. Works collaboratively with contracted outside collection agency (ies) to ensure payments and status of outstanding balances are communicated timely.  Reconciles our accounts with contracted outside collection agency (ies) monthly statements, ensuring accuracy of patient payment plan accounts.
9. Regularly reviews key performance metrics reporting to ensure organizational and department goals are met. Metrics including but not limited to time of service collections, aging accounts receivable, surgical deposits and appropriate and timely payment arrangements.
10. Performs daily problem solving and complex issue/dispute resolution for self-pay accounts receivables or balances after insurance.
11. Complies with the philosophy of Spectrum Healthcare Partners to collect patient balances through personal contact with patient/guarantor without disrupting the provider patient relationship.
12. Assists in development of training materials.  Participates in training of other staff on financial policies, time of service collection expectations, price estimations, etc.
13. May cover for other revenue cycle functions (such as check-in, check-out, pre-authorization, accounts receivables follow up, payment posting) as needed and assigned by Revenue Cycle leadership.

PRIMARY RESPONSIBILITIES

• Uses knowledge of third-party reimbursement to ensure that services have processed correctly through insurance, working closely with Patient Accounts staff when necessary.
• Complies with the requirements of the Fair Debt Collection Practices Act while performing daily work
• Maintains working knowledge of organizational policies and regulatory guidance.
• Assists with data gathering for financial reporting.
• Keeps abreast of current issues involving patient care or practice issues by attending and participating in department, team and practice meetings.
• Demonstrates professionalism always
• Displays cooperative behavior and interacts positively and effectively with others to promote a team environment.
• Is proactive in identifying, reporting and participating in the resolution of any potential or actual patient safety issues.
• Support the Company’s Vision and Values.
• Performs other duties necessary to maintain the overall efficiency and continuity of the practice.

QUALIFICATIONS

• High school graduate or high school equivalency credential; Associates degree preferred
• 2 years’ or more experience in healthcare with experience in areas of revenue cycle, billing, preauthorization, health insurance
• Third party billing or health care accounts follow up experience helpful and preferred.  Understanding of healthcare collection protocols helpful.
• Excellent customer service skills
• Attention to detail
• Excellent communication, organizational and interpersonal skills
• Ability to make well-reasoned decisions, both independently and as part of a team
• Ability to follow-through to meet patient, physician, and/or practice needs
• Ability to use discretion in handling confidential information; Ability to maintain confidentiality
• Ability to work independently and as part of a team; Ability to work collaboratively and effectively with individuals at all levels of the organization
• Proficient computer skills including email, Outlook, Microsoft Word, Excel and MS Office 365 Teams
• Prior experience with practice management systems preferred.

• Operation of various office equipment; fax machine, telephone & voice mail system, stationary/lap top computer, scanner, e-mail system, cell phone, pager, and copier
• Light lifting of paperwork, folders or other general record keeping materials
• Travel to various sites of service/clinics
• May be required to sit or stand for extended periods of time

Benefits and Perks

• Health Insurance (80% company paid)
• HSA Match ($3,000 family plan / $1625 individual plan)
• Dental & Vision Insurance Plans
• 401(k) Match and Profit Sharing Plan
• Life and Accidental Death and Dismemberment Insurance
• Long-term Disability Insurance
• Short-term Disability Insurance
• Generous paid time off
• Voluntary, Employee-Paid Benefits
• Medical Reimbursement Plan
• Dependent Care Plan

Powered by JazzHR

V8qI0gVQBs