Alex D.

Insurance Specialist, DCH Business Office, DCH Regional Medical Center

Working in Health Care: Insurance Specialist Claims Opportunities for Growth at DCH

My Education

• Dobbins is from Moundville, where he graduated from Hale County High School.

• He earned the Career Readiness Certificate in Industrial and Business Workforce from Shelton State Community College.

• While at DCH, Dobbins earned the Certified Patient Accounts Representative designation through the Alabama Chapter of Healthcare Financial Management Association.

• He also received a certificate of achievement from the DCH AIDET program.

 

Years at DCH

10 including experience in Registration, Emergency Department and switchboard, Northport Medical Center; Registration, Preregistration, Environmental Services and, currently, Accounts Receivable, DCH Regional Medical Center

 

Business Office Overview/ My Current Duties

Business Office operations are responsible for accurate registration of patient information, ensuring all insurance requirements are met and the successful resolution of patient accounts receivables. The operations are designed to ensure the organization has a positive cash flow, accurate insurance payments, compliance with all regulatory requirements and positive customer service.

 

- Skills needed: Dobbins is responsible for medical billing and following up on insurance claims to ensure the accuracy of payments from insurance carriers. Due to very specific guidelines from insurers, his job requires attention to detail. Good communication skills, whether by phone or computer, also are needed because he must deal with fellow co-workers, doctors’ offices and insurance companies.

 

- Being proactive: Dobbins primarily deals with Medicaid and must stay on top of ever-changing guidelines. As a development opportunity, he even took on out-of-state Medicaid enrollment contracts for all three DCH sites. DCH has to be enrolled as a provider to be reimbursed by out-of-state Medicaid agencies (e.g., when we provide services to a Medicaid patient from a state outside Alabama). “Doing the enrollments has helped me be aware of changes in insurance policies and guidelines,” Dobbins explained.

 

- Patience required: “You may have to send something to Medical Records for coding, and there are prior authorizations needed before certain services can be done for the patient,” Dobbins said.

 

What I Like About My Job

“Being able to receive the appropriate amount of reimbursement from insurance carriers. I know if we can get the maximum amount of reimbursement, then the patient will have to pay less out of pocket and the hospital will get the maximum reimbursement to help our bottom line.”

 

What’s Challenging

DCH must ensure that its medical coding is up-to-date so that it complies with Medicaid codes. Otherwise, Medicaid will reject a claim if it believes the wrong code or diagnosis has been used, Dobbins said. “In these cases, we have to go back and do research. The new managed care plans coming into effect make our work challenging, too.”

 

The Culture at DCH

Dobbins previously served on the AIDET Steering Committee, which focuses on improving patient satisfaction across the Health System. “Whether it’s direct or indirect patient contact, we try to make patients feel welcome here. It’s about making people feel the way you want to be treated.”

 

Why I Chose This Field

Dobbins’ sister is a DCH employee and persuaded him to apply, noting the advancement opportunities. “Some people might be passionate about a certain area, but they don’t have to stay there. (By transferring to another DCH department), you can go to where you feel you are most talented.”

 

Career Pointers for Greenhorns

“Education is key. Also continue to learn your talents and pursue them, even if you have to start at the bottom.”