Position Title: Patient Accounting Cash Application Technician Grade: F Department: Patient Accounting Reporting Structure: Operation Supervisor, Patient Accounting QUALIFICATIONS: REQUIRED TESTING: Ten Key Data Entry test (minimum 6000) Patient Accounting Terminology Test 35 wpm typing test REQUIRED: High School Diploma or GED Three years experience with automated healthcare billing systems. Must be able to identify and interpret Explanation of Benefits received from Multi Payors and patient payments or Three years medical claims processing or three years experience in posting insurance and patients. Two year customer service experience in a medical office setting One year PC and Windows skills Knowledge of basic accounting principles Must possess strong analytical and quantitative skills Three years experience working with insurance terminology, medical coding systems (CPT and ICD9), third party reimbursement procedures and Coordination of Benefits procedures. Must be detail oriented and have the ability to organize information Good communication skills, written and verbal, to establish and maintain effective working relationships, with internal and external payers and customers Ability to work and make decisions independently, perform under deadlines and assume responsibility for problems and problem resolution Flexibility - must be able to perform team duties as required to accomplish department goals and meet patient customer needs PREFERRED: Working knowledge of the following Medical systems: DEC/HCSS, Resolute (EPIC) and Medipac. PHYSICAL REQUIREMENTS: Ability to see (vision). Normal manual dexterity. Must be able to speak, read and write English fluently. Ability to sit for prolonged periods of time. POSITION PURPOSE: Service excellence is to be centered on patient care and patient relationships and is the responsibility of all employees. Teamwork is the norm and all employees will be held accountable to work as effective team members. This position is responsible for accurate and timely application and reconciliation of deposited payments. Initiates and completes research and resolution of overpayments and erroneous payments. Determines appropriate action to be taken on residual claim balances. Provides an important customer service link to internal and external customers. ACCOUNTABILITIES: Accountable for researching, applying and reconciling payments for daily lockbox activity including multiple complex payor insurance payments, Patient payments, also credit card payments and miscellaneous payments. Patient Accounting Department goal for lockbox is a one-day backlog. Access and understand necessary information of the various online Multi payor systems this includes: understanding the systems adjudication process in determining how a claim has been paid in order to accurately apply Insurance and Patient payments and adjustments and assists in determining the adjudication of a refund. Responsible for accurate and timely posting of electronic remittance errors and determining next course of action for residual claim balances. (e.g., Blue Cross, HealthPartners, Medicare, Medicaid, and Wausau). Prepare and submit refund request per refund guideline policy and procedure for refunds as needed. Responsible for demonstrating working knowledge of insurance sequencing rules and financial guidelines or laws regulating multiple complex payor medical billing. Responsible for researching and accurately distributing cash receipts with no apparent invoice number, or date-of-service. This includes: Finding the correct account for the cash if there is a valid patient/date of services. Accurately applying payment to correct invoice. Transferring to appropriate department. Generating refund if payment does not belong to HealthPartners or affiliates. Accountable for researching, applying and reconciling payments for inter-company transfers (e.g., Regions, RiverWay, Membership Accounting, Dental, North Suburban and Release of Information . Responsible for knowing and understanding benefit structures provided and administered by HealthPartners, its subsidiaries, and multiple insurance companies. Provides quality customer service for third party payers, members, patients, and attorneys concerning payments and remittances. Re-issue bills and statements when necessary and resubmit to appropriate parties. Responsible for reading, understanding and complying with all departmental and job-specific policies and procedures within the department. Perform demographic and insurance changes as needed on the patient's account to ensure accurate billing and cash application. Keeps abreast of current information and changes impacting Patient Accounting processes and organizes relevant information for daily reference. Assists in orientation for new Patient Accounting staff. Operates as a member of Patient Accounting Team in support of other staff. Completes assigned projects and duties in a timely manner. Informs management/supervisor of deficiencies/erroneous items or codes in Resolute (billing system) master files. Documents accounts worked according to departmental procedures. Identifies and proposes solutions to problems which contribute to customer dissatisfaction in order to reduce future complaints and errors. Responsible for reading and comprehending various complex Multi Payors Explanation of Benefits to apply payments and adjustments accurately. Requires understanding of co-insurance, deductibles and co-pays. Accountable for calculating proper adjustments and coinsurance per Explanation of Benefits and Multi Payor Listing provided by Corporate Contracting Department. Work with appropriate department/administrative staff to resolve questions and/or issues related to charges based on payments and denials received. Perform other duties as required to accomplish department goals and meet patient needs. 122630PatientAcctgCashApp_Tech.doc 3 We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.