ACCOUNTS RECEIVABLE SPECIALIST - PATIENT FINA
23 days ago
Plano
Job Description About Legent Health At Legent Health, our mission is simple yet profound: “To provide first-class health care that puts YOU first.” Our vision reflects our commitment to excellence: “Through robust physician partnerships, become a nationwide leader in compassionate, quality healthcare focused on the patient and available to everyone.” Our values, also known as our brand pillars, define how we stay true to our identity in the healthcare industry and the communities we serve. These values are central to everything we do: • Respect: We honor the time and trust of both patients and physicians by delivering organized, efficient services that ensure a seamless healthcare experience., • Service: We are committed to highly personalized care for patients, their families, and the physicians who serve them, driving optimal outcomes for all. About the Role The AR Specialist - Patient Financial Engagement will oversee patient accounts receivable management and early out collection strategies across our surgical facilities specializing in spine, orthopedic, ENT, and pain management procedures. This role is responsible for optimizing patient collections through proactive financial engagement, managing front-end collection processes, and ensuring timely patient communication throughout the revenue cycle. The ideal candidate will develop and implement strategic follow-up protocols, oversee statement processing timelines, and work collaboratively with registration, financial counseling, and billing teams to maximize patient collections while maintaining a compassionate, patient-centered approach. This position is critical to reducing bad debt, improving patient satisfaction scores related to billing, and accelerating cash flow from self-pay and patient responsibility balances. POSITION’S ESSENTIAL RESPONSIBILITIES: Primary Claims Management: • Manage surgical workers' comp claims from authorization through payment - Track all workers' compensation surgical cases from initial scheduling through final reimbursement, • Collaborate with Verification of Benefits team - Assist in reviewing compensability determinations, confirming active claim status, and identifying red flags that could impact payment, • Partner with coding team on documentation - Review operative reports and clinical documentation to ensure medical necessity is clearly established and services are appropriately coded, • Build strategic relationships with adjusters at major carriers to facilitate faster claim processing, • Coordinate with nurse case managers to ensure surgical procedures are properly authorized, • Engage with employer representatives when appropriate to clarify coverage issues or expedite approvals, • Maximize reimbursement under Texas fee schedules for surgical procedures, implants, and ancillary services, • Appeal underpayments and denials - Identify payments below fee schedule requirements or incorrect surgical reimbursement calculations, • Manage stop-loss and outlier provisions for high-cost surgical cases, • Track implant and device costs - Ensure proper billing for surgical implants, biologics, and high-cost medical devices, • Oversee early out program effectiveness - Monitor and optimize patient collection strategies within the first 120 days of service, • Manage patient AR aging buckets - Focus on 0-30, 31-60, and 61-90 day accounts to prevent progression to bad debt, • Implement strategic follow-up protocols - Design tiered communication strategies based on balance size, patient payment history, and procedure type, • Track and reduce patient AR days - Maintain aggressive targets for self-pay and patient responsibility collections, • Develop point-of-service collection protocols - Create scripts and processes for registration staff to collect copays, deductibles, and deposits, • Train front desk staff on financial conversations - Ensure staff can confidently discuss estimates, payment options, and financial policies, • Monitor POS collection rates by location and staff member - Identify coaching opportunities and best practices, • Implement pre-service financial clearance processes - Ensure patients understand financial responsibility before elective procedures, • Ensure timely statement generation - Monitor statement cycles to guarantee first statements within 5 days of claim adjudication, • Design patient-friendly billing statements - Work with vendors to create clear, easy-to-understand statements, • Implement multi-channel communication strategies - Utilize text, email, phone, and portal messaging for patient outreach, • Develop automated reminder campaigns - Create touchpoints at key intervals (pre-service, post-service, pre-due date), • Create balance-based collection strategies - Different approaches for small balance (<$500) vs. large balance accounts, • Implement propensity-to-pay scoring - Prioritize accounts based on likelihood of payment, • Design compassionate collection scripts - Balance revenue needs with patient sensitivity, • Develop escalation pathways - Clear protocols for when to offer payment plans, discounts, or financial assistance, • Manage payment plan programs - Oversee automated payment plan setup and monitoring, • Coordinate prompt pay discount programs - Track utilization and revenue impact, • Process financial assistance applications - Ensure timely review and determination, • Partner with third-party financing vendors - Manage relationships with CareCredit, AccessOne, or similar programs, • Track key performance indicators - Patient collection rate, POS collection rate, statement-to-payment conversion, • Analyze payment patterns - Identify optimal timing and methods for patient engagement, • Report on early out program effectiveness - ROI analysis and vendor performance metrics, • Monitor patient satisfaction scores related to billing experience, • Partner with Patient Access teams on upfront collections and estimates, • Work with Insurance Verification on patient responsibility calculations, • Coordinate with Customer Service on payment-related inquiries and disputes, • Collaborate with IT on patient portal enhancements and automation tools, • Excellent interpersonal skills - Ability to have sensitive financial conversations with empathy and professionalism, • Strong analytical capabilities - Interpret collection data and identify trends/opportunities, • Technology proficiency - Experience with patient engagement platforms, automated dialers, and payment portals, • Project management skills - Ability to implement new collection strategies and monitor results, • Training and coaching abilities - Develop staff capabilities in financial conversations, • Detail-oriented approach to payment posting and account reconciliation, • Understanding of healthcare billing, insurance EOBs, and patient responsibility calculations, • Knowledge of Fair Debt Collection Practices Act (FDCPA) and healthcare collection regulations, • Ability to balance revenue optimization with patient satisfaction and regulatory compliance, • Strong written communication for developing patient letters and scripts, • Experience with self-pay scoring models and segmentation strategies EDUCATION AND EXPERIENCE REQUIREMENTS: • Minimum 3-5 years of patient account management or healthcare collections experience, • Proven success improving patient collection rates and reducing AR days, • Experience with early out programs and vendor management, • Knowledge of front-end revenue cycle processes and point-of-service collections, • Understanding of payment plan administration and financial assistance programs, • Experience with patient statement vendors and communication platforms, • Experience in surgical facilities or specialty practices with high-dollar procedures, preferred, • Certification in Healthcare Financial Management (CHFP) or Revenue Cycle (CRCR), preferred, • Knowledge of automated payment posting and reconciliation systems, preferred, • Experience with predictive analytics and propensity-to-pay modeling, preferred, • Bilingual capabilities (English/Spanish) for diverse patient populations, preferred, • Background in customer service or patient advocacy, preferred Legent Health fosters an environment where team members are empowered to deliver exceptional care while growing professionally within a supportive, values-driven culture. We Offer: • Competitive salary and performance incentives, • Comprehensive benefits package, • Paid time off and wellness programs Legent Health is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, disability status, or any other legally protected characteristic. I-9 and E-Verify Compliance: Employment eligibility will be verified through the U.S. Department of Homeland Security’s E-Verify system. All applicants must provide valid documentation to establish identity and authorization to work in the United States, as required by federal law.
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