Patient Accounts Liaison - PFS Collections

Job Title: Patient Accounts Liaison | PFS Collections | Sioux Falls

City: Sioux Falls

State: SD

Department : PFS Collections-Comb

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

JOB SUMMARY

Provides consultation, recommendations, training, oversight and support to skilled nursing locations on the entire Medicaid pending collection process, including providing support to residents and a resident's responsible party, when necessary. Assists with appeals when a resident's application has been denied multiple times, collect on balances that Medicaid does not cover and determine when to engage an attorney.
Manages the Medicaid pending collection process for specific regions and/or states. Manages the Medicaid renewal/recertification process when a resident loses SNF Medicaid benefits. Provides consultation, recommendation and training to specific regions and/or states on the Medicaid pending process. Monitors aging's.
Identifies trends for the specific regions and/or states and implements action plans. Identifies accounts needing to be sent to a third party and follow-up on those accounts in a timely manner. Provides subject-matter expertise. Accountable for complying with all related laws, regulations and company policies.
Demonstrates the ability to work with Microsoft Office products such as Word, Excel and Outlook.

POSITION RESPONSIBILITIES

Utilizes privacy standards when sharing, accessing and storing data. Selects most appropriate communication approach depending on message and audience. Seeks information from resources such as major industry publications and professional associations. Prioritizes various problems in a timely manner. Operates customer support technology used within the organization. Explains the relationships with claims adjusters, insurance companies, outside legal counsel, and other claims related parties. Develops alternative techniques for assessing accuracy and relevance of information. Describes major tasks and responsibilities of a customer support function Communicates the importance of customer needs/expectations and commits to resolving them. Collects required data through various data sources. Clarifies basic principles, processes and terminology related to the insurance business.

DEPARTMENT DETAILS

The hours for this position are 8:00 a.m. - 4:30 p.m. with one night per week until 6:00 p.m.

QUALIFICATIONS

Associate degree required or four years' experience in a related field in place of a degree. Bachelor's degree preferred. Minimum of one year collection experience in healthcare and preferably long-term care required.
Knowledge of third party payers in a skilled nursing facility setting (Medicare A and B, Managed Care insurance, Medicaid etc.) preferred. Knowledge of Federal Medicaid regulations, knowledge of how to verify assets and locate/perform SKIP trace functions preferred. Knowledge of the Fair Debt Collection Process Act preferred.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing.
Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.
In addition to strong clinical care, we are also committed to research, education and community growth.
We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.
We continuously seek new ways to achieve our vision of improving the human condition here in your community, across the region and around the world.
The entire team at Sanford Health recognizes the value of healthy families and communities.
We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application,
please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

City: Sioux Falls

State: SD

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: WD14318