Patient Financial Services Analyst Job Code
30001427
Basic Function
To support Patient Financial Services Manager in the Patient Financial
Services department of the Johns Hopkins Aramco Healthcare (JHAH) Finance
Department. To execute activities across Accounts Receivable analytics and
reporting, and internal controls.
Scope
To support Patient Financial Services Manager in the Patient Financial
Services department of the Johns Hopkins Aramco Healthcare (JHAH) Finance
Department. To execute activities across Accounts Receivable analytics and
reporting, and internal controls.
Principal Contacts
Report to:
Patient Financial Services Director and Patient Financial Services Manager
Interact with:
Relevant internal and external stakeholders (Population Health, Physicians,
Nursing, Information Technology, Legal, Human Resources, Patients)
JHAH Finance (Financial Controller, Financial Planning & Analysis Director,
Finance team)
Revenue Cycle Management teams across Johns Hopkins International (JHI)
Principal Duties
a) Receivables management:
Charge Entry:
Receives and reviews charge documents from the clinic or charge router.
Ensures charge information provided is correct and accurate.
Review and retain hospital records in order to compute fees and charges due.
Balances Charge Summary to charge router workflows before updating charges.
Contact customers in order to obtain or relay account information.
Research and verify accuracy of billing data and revise any errors including
adjustments and denials.
Enters charges in a timely manner in a high volume setting.
Keeps supervisor apprised of matters regarding charge entry
Billing:
Reviews all claims and statements within designated alpha and discipline
before release.
Attaches required documentation to claims for payments.
Assists customers with billing questions.
Researches and corrects all denials received for designated alpha and
discipline.
Documents all correspondence with patients, insurance carriers, and vendors.
Other responsibilities as assigned.
Collector:
Identifies delinquent accounts, aging period, and payment sources. Processes
delinquent unpaid accounts by contacting patients and third-party payers.
Reviews accounts, credit reports, and other information sources such as credit
bureaus via computer.
Performs various collection actions including contacting patients by phone and
resubmitting claims to third-party payers.
Evaluates patient financial status and establishes budget payment plans.
Follows and reports status of delinquent accounts.
Reviews accounts for possible assignment; makes recommendations to credit
manager and prepares information for collection agency.
Assigns uncollectible accounts to collection agency or attorney via clinic
credit and collection policy. Contacts lawyers involved in third-party
litigation.
Payment Posting:
Responsible for posting all payments, adjustments and denials from all forms
of insurance payment to the appropriate claim
Responsible for posting of all patient received in mail payments
Send for review all zero dollars, denials and underpaid amounts.
Makes line item adjustments, as directed, for all zero pays and denials
Identify accounts that need to be refunded
Ensure correct payment processing
Close batches in system at end of the day
Run and analyze balancing report to ensure accurate posting
Completes all tasks received via the JHAH Epic dashboard, daily.
Scan all explanation of benefits into electronic chart
Answer questions from business office staff, providers, and supervisors
regarding payment posting, or the explanation of benefits
Understands coordination of benefits and payer responsibility
Ability to understand explanation of benefits and recognize underpayments
b) Policies and procedures:
Prepare and maintain JHAH’s financial policies and procedures based on best
practices applicable to the healthcare industry
c) Other responsibilities:
Support development of plans for ad-hoc projects and manage project team
activities to achieve given targets
Education
Bachelor’s Degree in Accounting, Finance or equivalent
Experience
Minimum 5 years of varied experience in a hospital environment
Knowledge of third party billing and collection processes, with particular
focus on billing requirements, contractual arrangements, utilization review
guidelines and certification / authorization processes for both institutional
and professional fees
Knowledge of accounting principles that directly impact the Accounts
Receivable, including debit and credit transactions, charge transfers,
contractual allowances and adjustments, financial class changes and revenue
reclassification, and reserve methodology and mechanics
Knowledge in charge master development for hospital
Knowledge of hospital operations and patient flow so as to be able to identify
and analyze potential sources of errors or patient dissatisfaction and reflect
these changes on the policies, procedures and processes
Knowledge of revenue cycle systems and methodologies to improve level of
automation
Knowledge of the Ministry of Health (MOH), GOSI and of the Council of
Cooperative Health Insurance (CCHI) regulatory environment so as to ensure
compliance with regulations regarding patient and insurance billing issues
Knowledge of CPT coding and ICD10 CM & AM coding
Knowledge of technology alternatives applicable to the patient accounting
environment – i.e., optical imaging, call center processing, collector
workstation
Understanding of medical terminology
Certifications/Other requirements as applicable
Fluency in both written and spoken Arabic and English
Relevant computer skills (MS Office, ERP systems)
Strong oral and written communication skills
Excellent analytical thinking
Autonomy
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