Horizon Health Corporation
PATIENT ACCOUNTS SPECIALIST
Horizon Health Corporation, Colorado Springs, Colorado, United States, 80509
Responsibilities
Patient Accounts Specialist – a full‑time (40 hrs/wk) position in a fast‑paced hospital business office. The role involves collecting on assigned patient accounts by contacting patients, insurance companies, and third‑party payors to resolve balances, reconcile receivables, and provide financial counseling. The specialist verifies insurance information within one business day of admission, meets productivity standards (minimum 30 accounts per workday), and earns additional compensation for meeting team collection goals.
Patient Accounts Collection
Identify and resolve claim delay issues that impact collections.
Follow up on payment errors, low reimbursement, and denials.
Accurately interpret Explanation of Benefits (EOB).
Initiate and track all appeals and reconsiderations as necessary.
Resolve incarceration, third‑party liability, and coordination of benefits (COB) discrepancies.
Work directly with insurance companies, providers, and patients to get claims processed and paid.
Utilize insurance provider portals, online chat, and IVR systems for claim resolution efforts.
Financial Counseling and Payment Coordination
Use knowledge of healthcare reimbursement, medical insurance, and payment negotiation.
Determine and communicate insurance benefits and patient self‑pay responsibilities pre‑admission.
Monitor and review new accounts and follow‑up documents for accuracy and completion.
Contact payors to clarify benefits and provide benefit education to patients, parents, and guarantors.
Meet patients/guarantors in lobby and on treatment units to secure upfront deposits, set payment plans, and complete financial paperwork.
Maintain a daily upfront collection spreadsheet.
Investigate delinquent patient information by contacting third‑party payors and patients to identify special circumstances affecting billing delays.
Prepare and maintain records and reports documenting insurance verification and upfront payment collections.
Additional Responsibilities
Create a positive customer experience for inbound and outbound calls, empathizing with customers while navigating systems quickly.
Document detailed notes with appropriate message codes.
Maintain current knowledge of insurance verification policies, procedures, and related legislation.
Notify the Business Office Director of any delinquent information.
Promote a positive work environment and guest relations.
Attend mandatory in‑services and comply with all safety measures.
Assume and/or perform additional duties as requested.
Qualifications Requirements: Demonstrated competency in the above criteria, ability to work independently and as part of a team, and experience with medical insurance. Working knowledge of Medicare/Medicaid regulations, policies, and procedures. Strong customer service, written and verbal, organizational, and interpersonal skills. Proficiency in Microsoft Word and Excel. Ability to maintain patient confidentiality and exercise independent judgment to manage time and meet deadlines. Successful completion of a background check and drug screen required.
Education/Experience: High school diploma or equivalent and at least one (1) year of experience in health care collections or a related field, or an equivalent combination of education, training, or experience in a healthcare business office environment.
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Patient Accounts Collection
Identify and resolve claim delay issues that impact collections.
Follow up on payment errors, low reimbursement, and denials.
Accurately interpret Explanation of Benefits (EOB).
Initiate and track all appeals and reconsiderations as necessary.
Resolve incarceration, third‑party liability, and coordination of benefits (COB) discrepancies.
Work directly with insurance companies, providers, and patients to get claims processed and paid.
Utilize insurance provider portals, online chat, and IVR systems for claim resolution efforts.
Financial Counseling and Payment Coordination
Use knowledge of healthcare reimbursement, medical insurance, and payment negotiation.
Determine and communicate insurance benefits and patient self‑pay responsibilities pre‑admission.
Monitor and review new accounts and follow‑up documents for accuracy and completion.
Contact payors to clarify benefits and provide benefit education to patients, parents, and guarantors.
Meet patients/guarantors in lobby and on treatment units to secure upfront deposits, set payment plans, and complete financial paperwork.
Maintain a daily upfront collection spreadsheet.
Investigate delinquent patient information by contacting third‑party payors and patients to identify special circumstances affecting billing delays.
Prepare and maintain records and reports documenting insurance verification and upfront payment collections.
Additional Responsibilities
Create a positive customer experience for inbound and outbound calls, empathizing with customers while navigating systems quickly.
Document detailed notes with appropriate message codes.
Maintain current knowledge of insurance verification policies, procedures, and related legislation.
Notify the Business Office Director of any delinquent information.
Promote a positive work environment and guest relations.
Attend mandatory in‑services and comply with all safety measures.
Assume and/or perform additional duties as requested.
Qualifications Requirements: Demonstrated competency in the above criteria, ability to work independently and as part of a team, and experience with medical insurance. Working knowledge of Medicare/Medicaid regulations, policies, and procedures. Strong customer service, written and verbal, organizational, and interpersonal skills. Proficiency in Microsoft Word and Excel. Ability to maintain patient confidentiality and exercise independent judgment to manage time and meet deadlines. Successful completion of a background check and drug screen required.
Education/Experience: High school diploma or equivalent and at least one (1) year of experience in health care collections or a related field, or an equivalent combination of education, training, or experience in a healthcare business office environment.
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