Location: Harlingen,TX, USA
GENERAL DESCRIPTION OF POSITION:
This is a full-time position with evening and weekend hours.
Responsible for verifying patient health insurance benefits, communicating with patients, and processing patient payments. Will work closely with patients, explain their benefits to them, communicate any insurance concerns, and many any insurance disputes. Will work with patients to explain treatment plans and options as recommended by dental provider ensuring patients understand the recommended procedures, associated costs, and available payment plans. Facilitate communication between the team and patients, acting as the primary point of contact for patient inquiries related to treatment plans and scheduling.
Will perform all duties which involve interaction with a patient in a manner which ensures the patient has a pleasant and satisfactory experience. All interactions with the patients will be in adherence to the PCMH principles, polices, and procedures.
Will be required to work overtime when needed to cover all night time clinics and weekends clinics.
ESSENTIAL JOB FUNCTIONS: (with or without accommodations)
Duties may include but not necessarily be limited to the following:
Accurately enters data and maintains current computer files of all patient demographics, insurance and account information. Accurately enters payments received on accounts, applying payments to existing charges and appropriately ensures account balances are paid currently and correctly through third party payers as well as patient payments.
Reconciles and balances daily Deposit Slip Report. Verifies insurance benefits on new and established patients, documenting coverage, deductible and contractual conditions for billing and collection purposes. Scans in insurance cards on every visit. At every visit verifies coverage through TMHP for all Indigent and Sliding Fee Scale patients. Sets tickets to correct payer source.
Communicates with patients and family members in both English and Spanish regarding projected charges, office polices, collection procedures, available programs i.e. Presumptive Title V, BCCS, DSHS and HTW etc. as necessary.
Confirms patient eligibility and benefits with various insurance providers is necessary to accurately tailor treatment plans to what is covered, thereby avoiding unexpected costs for patient.
Closely monitors accounts with pending Medicaid or other funding sources. Reviews aging patient tickets and makes collection efforts and documents accordingly.
Reviews credit balance tickets assigned and refers tickets to Supervisor if adjustments and or refund requests are needed.
Assists with any statistical or special reporting required by Supervisor or Administration. Obtains required signatures on all consent forms. Ensures all patients are given a receipt for payment. Provides and documents payment arrangements for outstanding balances and follows up on payment arrangements that have been made.
SPECIAL INSTRUCTIONS: This position requires handling of cash, collections, payments and billing and as such will require taking no less than five(5) consecutive days of accrued annual leave days per year. Therefore, five (5) of the accrued annual leave days will be reserved for this purpose.
Qualifications
Knowledge, Skills and Abilities: (use of equipment, job related knowledge, language, etc.)
Knowledge of PCMH Model
Knowledge of SCF polices and procedures
Knowledge of medical billing practices
Knowledge of ICD-10 coding
Knowledge in providing effective customer service on a daily basis
Knowledge of computer software (Microsoft Word, Excel, etc.)
Knowledge in the use of electronic mail
Skilled in the used of a computer
Ability of read, write and spell correctly
Ability to maintain and effective and professional working relationship with the public and co-workers
Ability to bend, stretch, stoop, stand, sit and lift up to 20 lbs.
Ability to operate a keyboard, telephone, and other office equipment
Ability to to examine documents for accuracy and completeness
Ability to prepare records in accordance to detailed instructions
Ability to communicate fluently in English and Spanish
Ability to maintain a positive work environment
Ability to work in a fast paced environment
Ability to maintain a flexible work schedule
Ability to maintain client and office confidentiality
Ability to work extended hours or other variations of the usual shift or duty station to ensure adequate care to patients and to maintain service to the community.
Minimum qualifications/certificates/licenses/registrations required:
High school diploma or GED. Must be bilingual English/Spanish. Minimum 6 months work experience in a medical office.