The Patient Accounts team within Sunnybrook Health Sciences Centre’s Finance department has an immediate opening for a Billing Analyst. This full time, temporary position will play an important role within this fast paced department responsible for billing and collecting revenues across the Hospital. Working with the Accounts Receivable Manager, clinical staff, physicians, patients, families and insurance companies this role will have responsibility for ensuring that all care provided to non-OHIP patients is billed and collections are optimized.

Summary of Duties:
Optimize the billing and collection of non-OHIP patient revenues by performing the following duties:

• Review appointment and admission lists to ensure all non-OHIP care provided across the Hospital is identified so the appropriate billing procedures can be initiated. Liaison with patients, physician offices and other Sunnybrook staff to confirm clinical treatment plans and determine the appropriate billing rates. Explain fees and required deposits to patients.
• Act as a subject matter expert on non-OHIP billing related matters and respond to questions arising from Hospital staff, patients and families.
• Validate situations where the patient has indicated they do not have sufficient funds to pay the bill and identify payment plans/alternative payment arrangements
• Liaison with insurance companies to confirm coverage and obtain guarantees of payment.
• Follow up on outstanding balances to maximize recoveries by:

o Negotiating collections from patients with complex, high dollar value accounts.
o Liaising with insurance companies, legal counsels, etc. as necessary to facilitate payments.
o Identifying problem accounts and recommending when they should be referred to the Hospital’s collection agency.
o Liaising as required with the Hospital’s collection agency to enable their success.
o Preparing and providing ongoing status updates to the Manager summarizing collection efforts and identifying key issues

• Responsible for reconciliation of general ledger balances and resolving reconciling items as needed.

• Investigate and resolve out-of-province billing rejections and prepare claims for resubmission.

• Liaison with billing representatives from other provinces to facilitate approvals for high cost procedures or to validate a patient’s coverage.

• Proactively seek opportunities to increase non-OHIP revenues by staying abreast of funding changes and networking with peers, along with developing new processes and procedures as required to more effectively capture these revenues.

• Regularly review non-OHIP rates to ensure optimal pricing.

• Ad hoc duties as required.

Qualifications and Skills:
In order to succeed in this role, the successful candidate must possess the following required and preferred qualifications and skills:

REQUIRED:

• Completion of a diploma program in Business Administration or equivalent.
• Minimum 5 years billing and collection experience. Hospital experience preferred.
• Have strong critical thinking skills to deal with complex and high dollar value patient billings.
• Exceptional verbal, customer relations and negotiation skills.
• Excellent written and oral communication skills with the ability to communicate effectively many different internal and external stakeholder groups Ability to deal directly with patients and families with sensitivity, patience and discretion.
• Advanced knowledge of MS Office suite of products (e.g. Word, Excel).
• Excellent organizational and time management skills with the ability to multi-task ad hoc projects, while ensuring the billing and collection goals are achieved..
• Demonstrated ability to work independently.

PREFERRED:

• Understanding of Canadian immigration policies and OHIP eligibility requirements.
• Prior work experience in a healthcare setting.
• Experience using HCRM/MediAR or other healthcare patient billing systems.