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Patient Services/Collections Specialist


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Location: Fall River, MA
Category: Health Care
Prima CARE, P.C. is looking to hire a Patient Services/Collections Specialist at its Fall River, MA site. Primary responsibilities will include:

Description PrimaCARE, P.C.
Positon:                      Patient Services/Collections Specialist
Location:                    Fall River, MA
Job Type:                    Full - Time
Job Description:
The Patient Services/Collection Specialist is responsible for checking in patient, verifying insurance, and reviewing the patient’s account for outstanding balances or estimates. We are there to service our patients and assist them in understanding any cost associate with their test along with explaining and outstanding balances. This staff member places an integral role in shaping the patient’s impression of the department which shapes the patient-provider relationship. This individual is a member of the team who is responsible for a variety of activities in the department including telephone reception, greeting patients/visitors, responding to inquiries from patients and providing information about the department and organization. HIPPA must also be maintained at all times to our patients. 
Essential Job Functions:
  • Upon check-in, all demographics are verified to include name, DOB, ordering physician and valid insurance information is scanned into the system.
  • All scheduled appointments within ECW are entered into the ECW schedule into the specific modality then the valid order is moved from future to current.  Document and organize check-in/out times for stats, walk-ins, etc.  
  • All x-ray appointments must be entered into both RIS and ECW.
  • If the study is requested with a wet read, proper wet read paperwork must be created.
  • Eligibility must be performed on all testing.
  • Waivers must be created, signed, and scanned into ECW for noninsured patients or patients with liability insurance, such as Worker’s Comp and MVA.
  • Create an x-ray order for all MRI patients that have not had a recent x-ray exam/per radiologist protocol.
  • Review of the patient's financial balance and if there is any estimate for the test patient is having done to determine if the patient needs to meet with patient services.
  • Outside orders scanned into ECW.
  • Research, record findings, and communicate effectively with Manager to achieve optimum performance.
  • Maintains patient confidence and protects medical office operations by keeping patient information confidential.
  • Contributes to team effort by accomplishing related results as needed.
  • Reviewing open accounts for collection efforts.
  • Making outbound collection calls in a professional manner while keeping and improving customer relations.
  • Answers questions from patients.
  • Identifies and calls collection department with resolving patient billing complaints.
  • Performs daily backups on office computer system.
  • Participates in educational activities and staff meetings are required.
  • Performs other duties as assigned.
 
Daily Work Flow Tasks
  • Computer literacy and multi-line phone experience- If no experience, the prospective coordinator must quickly become proficient with these tasks.
  • Establishes and Maintains Interpersonal Relationships — by developing constructive and cooperative working relationships with others and maintaining them over time.
  • Retrieves Information — by observing, receiving, and otherwise obtaining information from all relevant sources, like examining files or documents to obtain information.
  • Interacts with Computers — by using computers and computer systems (including hardware and software) to set up functions, enter data, or process information. 
  • Works Directly with the Public — by greeting and communicating effectively and helpfully with patients, general public and outside care givers. This may include communicating with patients, family and other outside providers following the Centers’ formal complaint process.
  • Documenting/Recording Information — by entering, transcribing, recording, storing, or maintaining information in written, electronic or hardcopy form. 
  • Monitor Processes and Surroundings — by reviewing information from the environment, to detect or assess problems.
  • Processing Information — by compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data. 
  • Updating and Using Relevant Knowledge — by keeping up-to-date technically and applying new knowledge to your job. 
  • Organizing, Planning, and Prioritizing Work — by developing specific goals and plans to prioritize, organize, and accomplish your work.
  • Assisting and Caring for Others — by providing personal assistance, medical attention, emotional support, or other personal care to others such as coworkers, customers, or patients. 
  • Getting Information — by observing, receiving, and otherwise obtaining information from all relevant sources.
  • Communicating— by providing information to supervisors and co-workers by telephone, in writing, by e-mail, or in person. 
  • Working with the Public — by dealing directly with patients and their family members.   
  • Establishing and Maintaining Interpersonal Relationships — by developing constructive and cooperative working relationships with others and maintaining them over time.
  • Organizing, Planning, and Prioritizing Work — by developing specific goals and plans to prioritize, organize, and accomplish your work. 
Expected Culture Elements/Behaviors
 
Quality & Caring
  • Acknowledges patients, providers and coworkers promptly with eye contact and a friendly greeting; handles phone calls professionally and courteously.
  • Contributes to creating a friendly comfortable environment where kindness, empathy and understanding are priorities.
  • Treats co-workers, patients and family members with courtesy, respect, dignity and professionalism, and with sensitivity to one’s values.
  • Demonstrates pride in what he/she does; is responsible for the outcome of our efforts and recognizes our work as a reflection of ourselves, our work team and our organization.
 
Integrity & Trust 
  • Actively listens and responds in a respectful non-confrontational manner to the opinions of others.
  • Fosters a spirit of cooperation and teamwork in the workplace.  Takes initiative to make things right; pitches in to help achieve common goals.
  • Verbal and written messages are communicated in a timely fashion and expressed in a clear, tactful, courteous and honest manner.
  • Resolves issues with productive solutions without placing blame.
  • Works to improve culture in workplace by recognizing positive behaviors and offering discreet and courteous feedback on behaviors that fall short of standards.
 
Adaptable and Flexible
  •  Flexible in meeting changing departmental needs in daily assignment changes.
  • Adapts to departmental and/or job changes as part of an on-going plan to improve service and/or offers creative alternatives.
  • Takes responsibility and accountability for assigned tasks, projects, and duties while maintaining a professional manner.
  • Considerate of patients and co-workers by being on time at the start of shift, taking the allotted time for breaks, and adhering to policies regarding work schedules.
 
Efficient & Resourceful
  • Makes efficient use of time, organizes and prioritizes work efficiently.  Achieves department productivity standards.
  • Takes initiative to streamline processes.
  • Anticipates and resolves problems in service delivery to patients, physicians, and other staff members.
  • Values the time of customers and other employees by providing prompt service.
  • Helps co-workers when own work is completed.
  
About PrimaCARE, P.C.:
Prima Care, P.C. was founded in 1996 and is a large, multi – specialty medical group serving southeastern New England.  With over 150 providers, including primary care physicians and a broad range of specialists, we offer quality health care, a diversity of services and treatments, convenient and friendly service, and state –of-the-art testing facilities to support your diagnosis and treatments.
In addition to our main Fall River campus and walk-in Center, Prima Care has medical offices and Walk In centers in Somerset, Westport, and Dartmouth, as well as satellite offices in Tiverton, Rhode Island.  We also provide care in patient’s homes, nursing homes and hospitals and two Outpatient Physical Therapy clinics located in Fall River and Somerset, MA.
We live and work by the golden rule and our company values that include integrity, respect, professionalism, ethical behavior and partnership. 

Benefits for our Permanent Placements Include:
Medical, Dental, Vision and Life Insurance.  401K/ROTH and Safe Harbor Plans.  Paid Time Off.
 
 

Requirements Minimum Requirements:
  • A High School diploma or graduation equivalency degree (GED) is required.
  • Strong computer skills required. 
  • Has at least 2+ years of experience working in healthcare environment with working knowledge of CPT, HCPCS and ICD-10 coding.
  • Ability to differentiate types of plans (PPO, HMO, Medicare, MassHealth products etc.)
  • Ability to communicate effectively with insurance carriers regarding reimbursement issues (benefits, adjustment, reviews, and authorizations) and has excellent communication skills, both verbal and written.


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Our Mission

 

At Prima CARE, our focus is the patient. We are by your side and on your side wherever you need healthcare, whether in the office, the hospital, the nursing home, the Ambulatory Care Clinic or at home where we make housecalls to home-bound patients. Our goal is the delivery of evidence-based medical care of the highest quality. Prima CARE is committed to the doctor/patient relationship through humanism, communication, empathy, compassion and respect, all joined together by trust.