Title: Patient Accounting Clerk (WORD version)

Industry: Health Care

Function: Accounting & Finance

Value-Added Results/Weights Performance Standards How to Track
Collected payments (25%)
  • • Correspondence
    		• • $X—$Y dollars collected/month from assigned payers.

    • No more than X%—Y% assigned receivables over 90 days old.

    		 • Payer report.

    • Aging summary.
    Bills received at insurance companies (25%) • 75%—80% claims with "bill received" before 50 days. • Enter "bill received" in Remarks field.
    Updated information and status in computer (10%) • 85%—90% "over 46 days" accounts have follow-up call recorded.

    • All follow-up is done within 30 days or within 1 week of missed payment.

    		 • Follow-up call date in remarks field.
    Solutions to pattern problems (10%) • Supervisor is satisfied that the Follow-up Clerk:

    • Documents enough accounts to confirm a pattern problem.

    • Summarizes information in useful form including account printout with all collection transactions and payment vouchers.

    • Corrects all of the accounts that fit the pattern.

    • Exceeds = Solutions are solved without supervisor involvement.

    		 • Document in Remarks field.

    • Employee logs pattern problems (date, payer, documents enough, resolution, etc.)
    Completed special projects (10%) • Supervisor is satisfied that the Follow-up Clerk provided all needed information by the agreed-upon deadline.

    • Exceeds = Providing necessary information that was not asked for.

    		 • Written assignment sheet.
    Collection process decisions (10%) • Supervisor is satisfied that the Follow-up Clerk’s decision:

    • Is supported by descriptive documentation.

    • Is made immediately or soon enough to be useful.

    • Moves toward resolution of the claim.

    • Is consistent with existing procedures.

    		 • Manager observation
    Up-to-date appeals (5%) • Manager is satisfied that:

    • Appeals are documented according to procedures.

    • Follow-up is completed within 30 days from receipt of latest utilization letter.

    		 • Follow-up date on report.
    Patient satisfaction (5%)
  • • Phone coverage

    • Patient billing arrangements

    		•  • Reduce the number of complaint calls or letters to supervisors compared to the previous month (shared by entire department).

    • Manager observation of phone calls indicates that the Follow-up Clerk:

    • Greets the caller correctly.

    • Asks if patient is willing to hold or wants to be called back.

    • Has a pleasant voice tone.

    • Calms irate patients.

    • Steer the conversation to the problem.

    • Summarizes what the patient asked for.

    • Exceeds = No irate calls had to be referred to the supervisor.

    • Available for coverage as scheduled for financial counselors.

    		 • Total # calls/letters received monthly.

    • Manager’s periodic use of a call observation checklist.