UNIVERSITY OF WASHINGTON

Specification for Class

PATIENT FINANCIAL SERVICES SPECIALIST 2

UW CODE AND REPRESENTATIVE GROUP

8082 (SEIU Local 925 Clerical Nonsupervisory)

CLASS SERIES CONCEPT

Process and resolve the patient accounts receivable for the University of Washington Medical Centers.

BASIC FUNCTION

Process all activity related to the Medical Centers' patient accounts receivable. Patient accounting functions supported include billing, follow-up, collections, patient concerns resolution, cash application and credit balance resolution.

DISTINGUSHING CHARACTERISTICS

Under general supervision, perform complex clerical patient accounting tasks in a computerized environment requiring specialized knowledge of third-party payer requirements and other patient accounting rules and regulations, and extensive communications with patients and other parties both within and outside of the Medical Centers.

Levels I and II are distinguished by scope of responsibility: Level I processes individual transactions on patient accounts. Level II has responsibility for considering the status of the entire patient account and for exercising judgment to determined appropriate course of action for resolution of the patient account in its entirety.

TYPICAL WORK

Review patient financial information to verify third-party payer requirements have been met and financial coding is correct;

Audit information on third-party claim forms for accuracy and completeness; transmit claims to third-party payers, including using a direct entry claims interface system;

Prepare and input allowances and adjustments to patient accounts according to third-party payer requirements and department procedures;

Access major payers' computer files on-line to obtain eligibility and claims processing information;

Respond to inquiries from patients, third-party payers and agencies, and other departments;

Analyze unpaid third-party claims to determine appropriate follow-up action to assure payment;

Analyze third-party contract reimbursement for accuracy;

Contact patients and payers by telephone to resolve account balances;

Process appropriate transactions to correct inaccurate account balances;

Prepare correspondence to address account concerns;

Analyze delinquent accounts with regard to billing and payment history and determine appropriate follow-up procedure based on departmental guidelines;

Analyze financial information provided by patients to determine their ability to make payment; advise patients on appropriate payment plans;

Determine charity allowances in accordance with the Medical Centers' Charity Care Policy;

Prepare accounts for transmittal to collection agencies when department collection efforts are determined to be unsuccessful;

Process according to department procedure accounts which have been identified as returned mail or bankrupt or decease patients;

Post and balance daily remittances to patient accounts; post allowances and adjustments accompanying cash remittances;

Resolve credit balances through allowances, adjustments, or refunds to patients of third-party payers;

Perform related duties as required.

MINIMUM QUALIFICATIONS - UW Contract Classified
DESIRABLE QUALIFICATIONS - Classified Non-Union

Level I: High School graduation or equivalent AND one year of experience in an appropriately related patient accounting function

OR

Equivalent education/experience.

Level II: High School graduation or equivalent AND two years of experience in an appropriately related patient accounting function.

OR

Equivalent education/experience.

Effective 10-1-94

CSR Class Conversion (mc): 06-01-05