At the Highest level, Catholic Hospice Employees must (a) be committed to Hospice philosophy and mission and (b) provide outstanding customer service, aligned with the Customer Service Guidelines, to both internal and external customers. Additionally, be able to promote an awareness and understanding of positive ethical and moral principles consistent with the mission, vision, and values of Catholic Hospice and those required by law. The Collection Specialist is responsible for performing all billing and collection functions related to Medicare, Medicaid, Private Pay, and Self Pay.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Commitment to Hospice philosophy and mission.
- Commitment and Implementation of Catholic Hospice's "Customer Service Guidelines."
- Ability to work professionally with multiple levels of management and promote co-operation among departments, teams, and staff.
- Computer literacy required with proficiency in word processing and computer applications.
- Ability to use computer system to generate reports related to utilization and billing from the Suncoast Solutions software program for day-to-day operations as well as for analysis purposes as necessary.
- Detail-oriented with excellent organizational and interpersonal skills
- Ability to take initiative, work independently, multi task, and prioritize.
- Must exercise good judgment and problem solving ability with systematic reviews.
- Must employ independent judgment to determine or ensure most efficient and cost effective approach to account resolutions.
10. Must possess general and detailed knowledge-base of insurance related collection strategies and be assertive when faced with claims related rejections.
11. Experienced in proper appeals related procedures for both governmental and private insurance companies.
12. Must be able to leverage efficiencies by establishing priorities and insuring seamless process compliance.
13. Ability to handle sensitive information, and maintain confidentiality.
14. Ability to manage multiple projects simultaneously, and meet hard deadlines.
15. Ability to adapt to change/new processes as necessary for continuous process improvement.
16. Must maintain very organized records or files.
17. Work product must be accurate and is subject to random and frequent auditing - internal, external and self.
18. Must be able to express creativity with problem resolution, while maintaining an open-mind to new ideas.
19. Work collaboratively with Admissions, Community Relations, and Interdisciplinary Team Managers and members to develop and integrate process improvement.
20. Ability to communicate effectively in English both orally and in writing.
21. Continual and proactive knowledge seeker to insure most accurate and up-to-date policies and practices both within the organization and related legislative rulings.
22. Ability to travel to any location throughout South Florida and expand territory as business needs dictate.
23. Ability and willingness to work a flexible Full Time schedule that may include weekends and Holidays.
- Researches and analyzes accounts prior to initiating debtor contact, examines historical data, evaluates past collection efforts.
- Access multiple databases for obtaining account status or entering data on assigned accounts; verifies accuracy before and after entry.
- Determines most effective and economical means of collection for each account; applies standard due diligence practices to collect monies owed; composes correspondence requiring knowledge of procedures and practices in collections and also sends a variety of standard collection letters.
- Coordinates with Admissions, Patient Care and Social Services Departments on Medicare, Medicaid, private insurance, HMO and self pay patients to obtain pre-billing information and approvals, to collect documentation and update billing files.
- Provides financial counseling to discuss and resolve the debt situation; restructures or revises payment terms within well-established limits and procedures; recommends hardship or other deferments when appropriate to supervisor.
- Applies payments received to proper accounts, keeping accurate accounting records of each transaction; reconciles records with computer reports, makes necessary adjustments or corrections.
- Assists Reimbursement Manager with Medicaid application by compiling necessary documentation and attending the designated appointments with the Department of Children and Families.
- Maintains billing files with up-to-date supporting documentation in compliance with insurer requirements.
- Maintains files (electronic and/or hard copy) on all past due accounts, documenting details of methods utilized to secure payment.
10. Compiles information and prepares a variety of reports on collection activities for supervisor, such as outstanding accounts and their current standing.
11. Generates reports related to billing from the Suncoast Solutions software program as required.
12. Serves as a back up to Reimbursement Coordinator
13. Other duties as assigned by Supervisor.
Ability to read, analyze, and interpret common information, reports and medical documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the Healthcare industry. Ability to effectively present information to management, public groups, referral sources or patients and caregivers. Ability to speak and write Spanish is strongly preferred.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to walk, sit and talk or hear. The employee frequently is required to use hands and fingers, to handle, or feel, sit for long periods of time, stand frequently, bend, squat, reach and turn to access files and office equipment. Must be able to lift up to 25 pounds.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Field positions will be exposed to various unfamiliar conditions which may include, but are not limited to: patient homes, nursing homes, assisted living facilities, doctor's offices and hospitals. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.