Accounts Receivable Specialist L/Ll

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.


POSITION SUMMARYThe primary purpose of this position is to perform a major segment of the accounts receivable support function through the follow-up process of all outstanding patient accounts within the Business Office.
QualificationsNECESSARY QUALIFICATIONSEducation:High School diploma or GED (Specialist I)Associates Degree in Business Administration, Finance, Accounting and/or Medical Billing Certificates (Specialist II)Experience:Specialist I: Must have one (1) year in a healthcare patient accounting setting as an Accounting Clerk/Technician, Finance Clerk, Accounts Receivable Clerk/Technician, and/or Accounts Payable Clerk/TechnicianSpecialist II: In addition to Assistant I requirement, must have three (3) years of experience in generating reports, preparing and monitoring accounting data and demonstrated experience in compiling and assisting in reconciliation of third-party billingOther Skills and Abilities:A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:
Positive working relationships with othersPossession of high ethical standards and no history of complaintsReliable and dependable; reports to work as scheduled without excessive absencesMust be able to work independently and be highly motivated, organized, and efficientExceptional verbal and written communication skillsAbility to prioritize daily, weekly and monthly work responsibilities effectivelyAbility to work under conditions of frequent interruptions and availability to work flexible scheduleMust be proficient with typing and accurate spelling/grammarProficient with the Microsoft Suite applications – Word, Excel, Outlook, Power Point, AccessCompletion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the jobSuccessful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the jobSuccessful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the jobSubmission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC.MENTAL AND PHYSICAL EFFORTPhysical:The work is primarily sedentary requiring the ability of prolonged sitting, occasional standing, walking, driving, bending, climbing, kneeling, crouching, twisting, maintaining balance, and reaching. Must be able to occasionally push, pull, and lift up varied weights according to job needs. Sensory requirements for position include prolonged use of near vision, hearing normal speech, and color vision: occasional sensory ability for far vision, depth perception, seeing fine details, hearing overhead pages on loudspeakers, and telephone use. Must have both hand manipulation in prolonged simple grasping and use of keyboard; occasional firm grasping and fine manipulation.
Mental:The incumbent applies specific rules, regulations, or procedure to perform a full range of related accounting and technical tasks, duties and assignments that are identified in Business Office third party collection process. Incumbent must have ability to prolonged need to concentrate and work in areas that are close and crowded; must be able to frequently cope with high level of stress, work alone, and demonstrate high degree of flexibility. Incumbent will need to occasionally make decisions under high pressure, cope with anger/fear/hostility of others in a calm way, manage altercations, handle a high degree of flexibility, handle multiple priorities in a stressful situation, and adapt to shift work. May occasionally accept a flexible schedule to meet unit needs, shifts include four 10-hour shifts and a second shift which includes evening hours.
Environmental:May rarely/occasionally be exposed to infectious diseases, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous or moving equipment, unprotected heights, and loud noises.
ResponsibilitiesESSENTIAL FUNCTIONSAccounts Receivable Specialist IRelies on instruction and pre-established guidelines to perform the functions of the jobWork under immediate supervision or team lead leaderAccounts Receivable Specialist IIRelies on limited experience and judgment to plan and accomplish goals and performs a variety of tasksWorks under general supervision with a certain degree of creativity and latitude, provides detailed reports to Supervisor/ManagerReviews patient accounts to determine status, makes standard adjustments that require special analysis, prepares and processes a variety of documents necessary for the maintenance and follow-up of all outstanding patient accounts.Examines work for accuracy, adequacy of documentation or citation, compliance with regulations, and justification of claims and other requests for payment for (1) services provided by TCRHCC (2) reimbursement of expenditures made by beneficiaries and non-beneficiaries for purposes such as medical care and treatment.Reviews delinquent patient account records, follows up with responsible parties via telephone and correspondence according to organization policy and procedures. Performs telephone contact with third party payers for amounts due on a timely basis. Maintains assigned collector work queue for follow-up with responsible parties on outstanding balances, makes financial arrangements in accordance with organizational policy and procedure.Utilizes knowledge of various insurance payer types including private insurance, Medicaid, Medicare, and managed care for effective billing and collections.Responsible for identifying patient accounts deemed non-collectable. Review accounts for possible reassignment and prepare information for collection agency.Identify and bill secondary/tertiary insurances.Identify and resolve customer and patient billing issues. Contacts responsible parties regarding discrepancies in payments if necessary. Resolves collections by examining customer payment plans, payment history, credit line: coordinating contact with collections department.Maintain and resolve Late Charge and Credit Balance accounts.Maintains financial security by following internal accounting controls. Secures financial information by completing data base backups. Maintains financial historical records by filing accounting documents.Participates in team huddles and team meetings to manage and plan effective patient care services. Participates and contributes to Performance Improvement requirements of the department and TCRHCC.Performs all other duties as assigned.Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction.
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