We have an exciting opportunity to join our team as a Financial Services Associate.
In this role, the successful candidate is responsible for ensuring maximum reimbursement to the Medical Center by managing patient accounts. Must successfully perform at least three of the following function: account services, account review, billing and collection activities
Performs other duties as assigned.
Account Services - Reviews patient folders, registration forms and charge documents to ensure that all information is complete and accurate. Enters, verifies and updates patient information (demographics, insurance benefits and charge data) obtained via face-to-face interviews or charge tickets into Eagle/Cerner system correctly. Links the patient, related party and coverage records to ensure that claims are filed correctly. Responds to subsequent requests for billing related information such as DRG worksheets, medical records, assignments, etc. Provides thorough review of accounts to be reclassified to alternate carriers and accurate data entry of related benefit revisions.
Billing Services - Submits clear and accurate claims to third party carriers on a timely basis. Utilizes electronic follow-up system to perform billing activities. Confirms receipt of third party claims; re-bills claims as necessary. Monitors the status of patient admissions to ensure the earliest possible release of accounts ready for billing. Is cognizant of time limits currently in effect for all billing activities and monitors for compliance.
Account Review - Reviews trial balance, HTS, third party vouchers etc. to determine accounts requiring action. Verifies that the account has been properly billed; identifies that payment has been applied to the proper service date and reference number. Checks account with outstanding balances to determine whether account should be cancelled and re-billed, billed to secondary carrier/patient or refund prepared. Reviews charges/payment and transfers to another account or reference number if warranted. Identifies reason for denial or delay of payment; pursues payor/corrective action to resolve claim.
Verifies existing charge codes and charges in system in order to issue a corrected bill. Resolves credit balances by reviewing accounts thoroughly; pursues refund or adjustment as appropriate. Accurately calculates patients payment responsibility upon admission, discharge, at point of service and/or after third party payment. Reviews high dollar and/or aged accounts in order to facilitate timely reimbursement from third parties. Clears accounts with small balances by sending final bill to the patient or initiates write-offs when situation warrants (e.g. contractual allowances, VIP, employees).
Collection Activities - Follows up with patients and families to obtain additional insurance information or to arrange payment plan. Reviews high dollar and/or aged accounts in order to facilitate timely reimbursement from patients, governmental or third party carrier. Clears accounts with small balances by sending final bill to the patient or initiates write-offs when situation warrants (e.g. contractual allowance, VIP, employee). Determines when accounts should be transferred to inactive pre-legal status for collection activities. Demonstrates knowledge of Eagle/Cerner/Onbase system capabilities to investigate and resolves collection problems. Follow-up with governmental and third party carriers to obtain payment.
Pre-Legal/Legal - Verifies payments which have been collected through other channels (e.g. collection agencies) and takes appropriate action. Works with collection agencies to resolve open issues regarding accounts. Reviews referrals to determine appropriate avenue for further collection. Reconciles vendor acknowledgements, status closed reports and remittances/invoices to ensure the integrity of inactive trial balances and related financial reports. Reviews and including affidavits, bankruptcy notices and estates. Assists outside counsel in court cases as directed.
Customer Service - Greets patients/visitors promptly in a courteous and professional manner. Provides and solicits correct information to and from patients/visitors as needed or requested. Answers telephones and inquiries promptly and courteously. Directs telephone calls and visitors appropriately based on the nature of the inquiry. Resolves routine to complex problems to ensure complete account resolution. Resolves customer inquiries in a willing and thorough manner.
Correspondence - Prepares correspondence which is clear, grammatically correct and meets content requirements. Sends out responses promptly. Routes complex correspondence to the Team Leader/Manager and attaches related records or information to the correspondence.
Documents/Forms - Completes the information correctly and neatly (i.e., adjustments, refunds). Initiates documents/forms follow-up as needed in order to expedite or track its progress through the processing system. Secures accurate signatures and forwards documents/forms to the appropriate destination based on the pertinent Medical Center procedure.
Recordkeeping/Filling - Records and calculates the information accurately according to departmental procedures. Records information on departmental or area records promptly in order to maintain them in an up-to-date manner. Analyzes and makes reasonable attempts to resolve discrepancies. Maintains records in an organized and up-to-date manner; establishes filing system which allows for the prompt retrieval of all information. Completes filing accurately and promptly. Maintains information required for audit of the department in accordance with Medical Center, Federal, State, and City Agencies regulations. Reviews and purges files as appropriate. Assures supporting documents (e.g. EOBs correspondences, signatures, etc.) are imaged or otherwised filed.
Data Collection - Prepares the requested data thoroughly and accurately. Obtains information within established time frame. Utilizes appropriate sources and assembles data in accordance with instructions. Gathers correct and up-to-date information. Responds to audit requests within established guidelines.
Judgment/Decision-Making - Demonstrates the ability to exercise good independent judgment based on the application of the appropriate policy or procedure. Obtains and analyzes all pertinent information available in order to make the most informed decision based on factual and objective data. Is able to foresee a potential problem situation, intervenes, if appropriate, or advises supervisory personnel of the situation. Advises appropriate personnel of issues requiring follow-up attention. Uses policy and procedure manuals, office procedure manuals and/or other reference materials as necessary to ensure accuracy and a proper course of action. Uses supplies efficiency in order to minimize waste of materials. Maintains an awareness of the cost impact of decisions and actions.
Initiative - Makes appropriate suggestions which would enhance or benefit the area or department. Volunteers assistance and guidance to others, when needed. Demonstrates a flexible and cooperative response to departmental changes. Demonstrates an active interest in improving current level of skills and knowledge by pursuing higher education or attaining new skills. Maintains work area in a neat, organized and professional manner. Seeks additional assignments when work is complete.
Planning and Time Utilization - Demonstrates the ability to recognize, establish, and attends to priorities promptly. Strives to make good use of time during the assigned shift through careful coordination of daily task. Demonstrates flexibility in adjusting to the fluctuating needs of the department and Medical Center. Coordinates own work to achieve an appropriate level of productivity, efficiency and quality services. Is able to organize time efficiently and completes work within established timeframes.
To qualify you must have a Associate's Degree preferred but not required plus 2-3 years experience in patient accounts or in a related field or an equivalent combination of education and experience. Knowledge of third party operations and familiarity with automated patient accounting systems required. Excellent communication and interpersonal skills required
Knowledge of PC applications preferred
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history.