Job Description

LOCATION

: KONA COMMUNITY HOSPITAL | Patient Accounting

POSITION STATUS

1.00 | Permanent

SALARY RANGE

BU03 | SR17

SALARY RATE:

$26.33 (Annual Salary) based on the Full Time Employment

JOB DUTIES

A. Patient Account / Billing & Collection Responsibilities

1. Maintains knowledge of Registration and clinic billing forms.


Bills out patients on appropriate claim forms (i.e. Hospital Claim form, UB-92 (Uniform Billing), Medicaid Drug Claim Form 204, Physical Claim Form HCFA 1500.


2. Verifies Healthcare Common Procedural Coding System (HCPC) codes, and Current Procedural Terminology (CPT) codes pass systems edits.


3. Obtains correct information for all rejects; follow up on accounts.


4. Meets deadlines and ensures claims are paid appropriately.


5. Follow up on billing errors and makes appropriate adjustments.


6. Evaluates patients for charity care services.


7. Independently identifies missing charges or make corrections as necessary.


8. Assures that proper CPT and HCPC's codes are used and corrects and updates claims as necessary.


9. Works with patients or non contracted payors to expedite payment.


10. Answers inquiries pertaining to accounts either by telephone or through correspondence.


11. Resolves all billing/collections issues.


12. Interviews patients and/or responsible parties to obtain financial information to determine ability to pay.


13. Monitors the installment plans or payment arrangements for timeliness and consistency. Contacts patient or responsible party who is delinquent in making payment or fulfilling promises.


14. Re-files claims with Medicare, Medicaid, HMSA, and other insurance carriers if claims are not settled within 60 days from date of initial claim.


15. Determines the collectability of accounts that are approaching over 120 days aging category.


16. Reviews specific aged trail balance report to identify uncollectible accounts. Investigates the nature of the complaint or question and the history of events leading up to the clinic charges.


17. Receives, investigates, resolves, and reports complaints and questions relating to clinic bills.


18. Identifies the issues impeding the collectability of an account, from the quality of admissions data to the inappropriate payor billing.


19. Documents, updates and corrects all communication regarding the account history in the billing system.


20. Reviews accounts that are recommended by Attorney General's Office, Collection Unit, for legal action.


21. Appears in court when necessary to present proof of outstanding debt.




22. Retrieves accounts that have been written off or cancelled when reinstatement becomes necessary.

B. Coding Responsibilities

1. Performs routine quantitative chart analyses for discrepancies and for correction and/or completion by physicians, nurses, and clinic staff.


2. Codes diseases, operations, and special therapies according to the International Classification of Diseases and Current Procedural Terminology guidelines.


3. Inputs clinical data, which provides indexes of diseases and operations according to established plans and procedures.


4. Carries out routines of follow-up systems for patient care and special projects.


5. Analyzes and codes accurately on a timely basis for billing purposes.




6. Coordinates with physician any possible discrepancies in questionable diagnosis.

Other Duties:

1. Contacts Maintenance and initiates work orders for immediate repairs needed.

THE MINIMUM QUALIFICATION REQUIREMENTS ARE:

Applicants must meet all of the following requirements. Please note that unless specifically indicated; the required education and experiences may not be gained concurrently. In addition, qualifying work experiences are based on a 40-hour work week.


Other information:

EDUCATION REQUIREMENT:

High school diploma or equivalent.

GENERAL EXPERIENCE:

Two (2) years of typing, stenographic, clerical work, cashiering, data input, customer service skills or any combination of these experiences which duties demonstrated knowledge of English grammar, spelling, arithmetic, standard office equipment; and the ability to read and understand oral and written instructions, carry out procedures in clerical work systems, speak and write simply and directly, observe differences in copy and proofread words and numbers quickly and accurately, and operate various kinds of office equipment; and ability to deal effectively with others in eliciting information and providing service.

SUBSTITUTION OF EDUCATION FOR GENERAL EXPERIENCE:

An Associate's or Bachelor's from an accredited college or university may substitute for all of the General Experience required.

SPECIALIZED EXPERIENCE:

Three (3) years of work experience performing medical billing and collections in a hospital, long term care facility, outpatient clinic or clinic setting; interviewing patients and/or responsible persons to secure financial information, arranging for method of payment and extension of credit, and determining financial status; reviewing accounts for delinquent payments and contacting payer to seek payment.

SUBSTITUTION OF SPECIALIZED EXPERIENCE:

Work experience performing billing and collections in an organization (i.e., financial institution, retail, or hotel); interviewing persons to secure financial information, arranging for method of payment, extension of credit, reviewing accounts for delinquent payments and contacting payer to seek payment may substitute for one year of Specialized Experience.

QUALITY OF EXPERIENCE:

The number of years of experience required for any grade level represents the minimum amount of time necessary to qualify for the appropriate position, but length of time is not in itself qualifying. The applicant's work experience must also have been of a quality and scope sufficient to enable him to perform satisfactorily assignments typical of the grade level for which he/she is being considered.

KNOWLEDGE AND ABILITIES REQUIRED:

KNOWLEDGE OF:

Working knowledge of medical billing, collections and follow-up in a hospital, long term care facility, outpatient clinic or clinic setting. Working knowledge of Healthcare Financing Administration (HCFA) UB92, UB04, HCFA 1500 Claim forms, third party insurance (i.e., Medicare, HMSA, Medicaid); rules, regulations and requirements of medical billing, International Classification of Diseases - 10th Revision (ICD-10), Current Procedural Terminology (CPT), Healthcare Common Procedural Coding System (HCPCS), Diagnosis Related Group (DRG), and Resource Utilization Groups (RUGS). Knowledge of credit and collection methods; Fair Debt Collection Practices Act (FDCPA); principles and techniques of interviewing; and office practices and procedures.

ABILITY TO:

Collect, organize and evaluate facts; be tactful and objective in interviewing and dealing with people; present information clearly and comprehensibly both orally and in writing; apply the laws, rules, regulations, policies and procedures pertaining to the work.


ALL CIVIL SERVICE JOB VACANCIES WILL BE POSTED FOR A MINIMUM OF TEN (10) CALENDAR DAYS



The Hawaii Health Systems Corporation is an equal opportunity employer and complies with applicable state and federal laws relating to employment practices

QUALITY OF EXPERIENCE:

Possession of the required amount of experience will not in itself be accepted as proof of qualification for the position. Overall paid or unpaid experience must have been of such scope and responsibility as to conclusively demonstrate that you have the ability to perform the duties of this position. Provide a detailed description of your duties and responsibilities. If you worked on a part-time basis, indicate the average number of hours worked per week. Please note that experience will be based on a 40-hour workweek. Note: We will not postpone the recruitment process because of your failure to provide accurate and complete information concerning your qualifications.

MERIT OR CIVIL SERVICE SYSTEM:

You must meet the minimum qualification requirements, including education, experience, other public employment requirements for State Civil Service employment, and HHSC Standards of Fitness. Only those applicants that are scheduled for an interview with the hiring manager will be contacted.

CITIZENSHIP AND RESIDENCE REQUIREMENT:

Applicants must be a citizen, national or permanent resident alien of the United States or a non-citizen eligible under the federal law for unrestricted employment and at the time of appointment intend to reside in the State of Hawaii during the course of employment with the Hawaii Health Systems Corporation.

VETERAN'S PREFERENCE:

If you are claiming Veteran's Preference, you must submit a copy of your DD214 and/or other substantiating documents specifying the periods of your service.

HEALTH AND PHYSICAL REQUIREMENTS:

Applicants must meet the health and physical requirements deemed necessary to effectively and safely perform the essential functions of the position with or without reasonable accommodation. Hawaii Health Systems Corporation is committed to making reasonable accommodations on a case-by-case basis. Applicants seeking reasonable accommodations should be ready to discuss the accommodation sought so that a determination can be made that such accommodation is reasonable and would not cause the employer undue hardship.

MEDICAL/PHYSICAL EXAMINATION REQUIREMENT:

Offers of employment will be contingent on successfully passing a pre-employment physical examination, which includes drug screen and other regulatory medical requirements such as, but not limited to, two-step tuberculosis (TB) screen. The cost for physical examinations, except the cost for drug screening, shall be borne by the applicant and not the Hawaii Health Systems Corporation.

CRIMINAL/GROUND, CREDENTIALING CHECKS:

Applicable checks will be conducted periodically, and any associated costs may be borne by the applicant. Applicable checks may include, but are not limited to, state and federal criminal history records, child abuse and neglect registry check, adult protective services registry and sex offender registry records, etc. If a job offer is made or employment is begun prior to completion of all applicable checks, any offer of employment or continued employment is contingent upon satisfactory return of all required checks.

IMPORTANT APPLICATION/EMPLOYMENT INFORMATION

Administrative Review, subsequent appeals: If you do not agree with a decision made by the Employment Office as to your non-qualification or non-selection for a position, you may complete a Request for Administrative Review form (available on the HHSC website) or you may submit a written request within twenty (20) days from the date of your sent notice to the Regional Chief Executive Officer/Designee. Your letter requesting the Administrative Review must include: 1) The job title(s) and recruitment number(s), 2) the specific reason(s) you are requesting the review noting if there is statute or rule violation, and 3) any additional information you want to submit to substantiate your request. If you do not submit your request within the twenty (20) days deadline, no Administrative Review will be conducted. Since the Administrative Review is a prerequisite to subsequent steps, failure to utilize this process will make you ineligible for subsequent appeals. The administrative review, formal complaint and/or appeals hearing will not necessarily postpone the recruitment process and/or rescind a selection. If you do not agree with the Administrative Review, you may file a Formal Compliant and then, if you are still not satisfied, you can appeal to the HHSC Merit Appeals Board.

CONTACT INFORMATION

: KONA COMMUNITY HOSPITAL is located at 79-1019 Haukapila Street Kealakekua, HI 96750. For employment opportunities, please contact (808) 322-4458, email: konajobs@hhsc.org or visit our website at https://www.hhsc.org/.


Persons with Disabilities may contact the Recruitment Office to discuss special needs in applying at (808) 322-4458, konajobs@hhsc.org.