Cost Center
901 ORS AdminScheduled Weekly Hours
40Work Shift
First Shift (United States of America)Shift & Status
Who Are We?
We at Pine Rest believe in the power of healing and that everyone in our community has the right to expert care for mental health and substance use disorders. We are much more than just the third largest non-profit behavioral health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers who witness the impact of our life-changing work each day.
Each day, we are closing the gaps in access to care. We are innovating through leading-edge research, testing, programs, and treatment modalities that others replicate across the country. Our services include a state-of-the-art psychiatric urgent care center and a soon-to-be-built pediatric behavioral health center, outpatient, inpatient, partial hospitalization (day programs), assessment and testing, residential, addiction treatment and specialty services such as crisis response, employee assistance programs, forensic psychiatry and psychology, and neuromodulation. On-the-job educational programs for nurses, psychologists, advanced practice providers, psychiatrists, and chaplains are equipping the next generation of care providers.
We are passionate about serving and are honored to be a part of this incredible work.
What Will You Do?
As a Patient Account Specialist at Pine Rest, you’ll be part of tight-knit team that believes in the healing power of your expertise and compassion. Under the direct supervision of the Support Staff Supervisor, independently performs administrative duties related to billing, collection, accounts payable, accounting, and customer assistance. The Patient Account Specialist is dedicated to excellent customer service, enthusiastic about the care we offer, and foster a sense of belonging and empowerment in a diverse workplace.
Principal Duties and Responsibilities:
Maintain patients’ accounts including: verifying patient demographic information is populated, ensuring all guarantors are entered correctly, creating a supervision relationship or patient responsibility if appropriate, completing authorization reports, adding new payer information, verifying benefits, controlling patient balances, and verifying patients are scheduled with a participating provider.
Contact insurance companies to obtain preauthorization, resolve outstanding balances, incorrect payments, claim denials or information needed to adjudicate claims. Work with clinical areas to resolve rejections and determine collectability or need for adjustment.
Responsible for Medicaid/Medicare reporting. Ensure that patients have necessary agreements on file.
Process any failed claims assuring claims meet the clean claim definition to assure timely and accurate payment.
Apply patient payments to accounts, monitoring for compliance with contractual agreements to assure appropriate reimbursement for services provided. Prepare and balance bank deposits.
Answer patient questions regarding balances, make referrals to other areas as appropriate, i.e. clinical area, Patient Rights, etc. Create and maintain customer-friendly environment with internal and external customers.
Establish payment arrangements within established guidelines.
Review accounts to determine patient delinquency and initiate collection steps or refer to collection agency.
Responsible for the monitoring and careful use of resources impacting them in a moderate capacity (i.e. writing off balances, application of PAF funds, etc.).
Responsible for the application of PAF funds and entry of PAF data.
Maintain knowledge of payer regulations, contracts and billing requirements and act as a resource to clinical sites regarding these requirements.
Offers or delegates administrative support including but not limited to the following tasks: greeting, answering questions based on knowledge, scanning and copying, letters of correspondence, monitoring clinical staff schedules (i.e. referral scheduling, maintaining of cancellation list and coordinating model of care appointments), and front desk duties (i.e. check in/out of patients, answering and triaging patient phone calls, and opening/closing responsibilities).
What Does This Role Require?
Education/Experience:
Work requires the ability to read, understand and follow directions, and do computations at a level typically acquired in high school or equivalent. An Associate’s Degree or equivalent knowledge, skills, and abilities may be required.
Requires minimum experience of one year in related field.
Benefits:
Medical, dental, vision & life insurance plans
403(b) retirement match contribution by Pine Rest
Generous PTO for full and part time employees
Tuition assistance & loan forgiveness
Employee Assistance Program offering many free and discounted services for therapy, legal, accounting, gym membership, etc.
Partnership with Davenport University provides generous discount on tuition for employees and family members.
Notice:
Pine Rest provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
All new employees are subject to a criminal background check and education verification which may include sending a copy of your high school diploma, GED, or college transcripts.
Successful completion of a drug screen prior to employment is also part of our background process.
Pine Rest Christian Mental Health Services requires all employees to receive the COVID-19 vaccinations subject to certain exclusions. Pine Rest is committed to granting reasonable accommodations in accordance with applicable laws.