Patient Financial Services Representative

Position Summary

Career Interest : The Patient Financial Advisor is responsible for providing financial assistance to all patients and families throughout the health system.

Assists patients and families to secure payer sources including insurance coverage, Medicaid / Medicare and other sources available based on need.

Follows the enterprise financial clearance and financial assistance policy and procedures. Maintains productivity, quality and customer service requirements according to department policy and procedure.

Responsibilities and Essential Job Functions

Contacts the patient or family by phone or in person to ask them questions about sponsorship linkage. Includes health insurance, homeowner’s insurance, workman’s compensation insurance, pre-paid packages, grants, studies, COBRA, VA benefits, Crime Victim, auto insurance, Medicaid or Medicare.

Complies with Medicare / Medicaid rules and regulations.

• Screens patients with financial needs and assists them in finding payment resolution for their accounts. Includes negotiating settlements, insurance, public assistance, payment arrangements, charity or bad debt.
• Updates patient account information and patient demographic information appropriately. Reviews the account within 1 business day to assure verification and pre-certification are complete and accurate.
• Determines possible Medicaid or Disability linkage for patients as needed; this includes the ability to interpret the patients H&P to determine disability.
• Negotiates settlements or makes payment arrangements. If unable to make payments, then screens for partial or full charity, this includes completing the financial assessment application and obtaining all necessary documents.

If the patient is uncooperative at any part of the screening process, their account(s) will be recommended for collections and ultimately bad debt.

• Works daily WQS consisting of all unsecured accounts. Requires taking appropriate actions necessary such as phone calls and written communication and using appropriate codes and time frames.
• Assists ""walk-in"" customers requesting assistance, and customer service calls with questions.
• Processes Care Management Team referrals for Sponsorship.
• Responsible for Point of Service collections and EPIC documentation when applicable.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities.

Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• High School Graduate or GED.
• Must be able to type 45 wpm.
• 3 or more years of combined experience in financial advising, claims processing, collections, customer service, or revenue cycle positions (includes admitting, patient accounting, prior authorizations, or pre-registration).

Preferred Education and Experience

• 1 or more years of experience in Epic.
• 1 or more years of experience in CPT-4 and HCPCS coding.
• 1 or more years of experience in Microsoft Word and Excel.

Knowledge Requirements

• Ability to multi task, prioritize, and escalate.
• Good oral and written skills.
• Knowledge of Insurance (Commercial & Government)
• Knowledge of payor websites
• Knowledge of transplant (BMT and / or Solid)
• Working knowledge of CMS regulations

Time Type : Job Requisition ID :

Job Requisition ID : R-38193

R-38193