Ensures collection of patient balances, deductibles and co-pays in an accurate and timely manner. Serves as a resource to patients, families, and employees to discuss financial arrangements and properly explain patient financial obligation. Assists patients with any applicable financial assistance programs. Performs a treatment initiation approval process by review of ordered/prescribed services relating to insurance coverage policies and pre-certification/authorization requirements, while securing amicable payment arrangements. Performs other duties as assigned.Job Responsibilities
• Works with patients, families, staff, and representatives from outside agencies to collect deductibles and co-pays, set up payment plans, and evaluate bad debt.
• Assists patients with initiation of the application for Charity Care and/or patient assistance drug replacement programs.
• Serves as a resource to properly explain insurance benefits to patients, families, staff, and representatives from outside agencies as to how they pertain to the services being performed at this facility.
• Understands and complies with regulatory requirements by specific insurance companies and facilitates compliance by maintaining awareness of guidelines and ensuring compliance through communication and documentation to appropriate staff.
• Registers patients accurately, efficiently, and professionally to ensure data base integrity and facilitate claims processing.
• Expedites patient flow through prompt and courteous service.
• Responsible for the creation of a means to facilitate collaboration and standardization across all venues of care within the healthcare entity in support of treatment initiation approval process and validation of covered indications relating to the ordered/prescribed procedures.
• Completes assigned goals.
Experience Minimum Required Preferred/Desired
Three years of business related office experience with one of those years being in a clinical setting.
Five years of business experience in a clinical setting environment. Front-end collections experience desired. One year minimum experience performing pre-certification/authorization functions within a hospital and/or clinic environment. Education Minimum Required Preferred/Desired
High school diploma or equivalent required. Skill in communicating clearly and effectively using standard English in written, oral, and verbal format to achieve high productivity and efficiency. Three years of business experience in a clinical setting environment.Special SkillsMinimum Required Preferred/Desired
Excellent customer service and communication skills. Ability to speak, articulate, and be understood clearly. Skill to write legibly and record information accurately as necessary to perform job duties. Basic computer skills to include MicroSoft office literacy knowledge required. Ability to perform basic math computation. Dealing with confrontational issues and high stress situations with patients, family, and physicians. Strong quantitative, research, analytical, problem solving, and organizational skills. Must have team - oriented work ethic with strong interpersonal skills. Prioritizes and performs work responsibilities independently or with a minimum of supervision.LicensurePreferred/Desired
Knowledge of EPIC application of cash postings and registration processes. Insurance verification processes using Real Time Eligibility, Passport Communications, and additional on-line verification processes. Knowledge of pre-certification requirements and guidelines. Knowledge of medical coding methodologies.
Associates degree or two years of college level courses.