Patient Financial Specialist at Signature Health Inc – Kirtland, Ohio

At Signature Health, our purpose is to provide integrated healthcare for our community specializing in patients with mental illness and/or addiction because we want people to realize their highest potential. If you align with our core values, putting people first, striving for excellence in the work you do each day and have a can do mindset, then Signature Health is the best place for the next step in your rewarding career. As a full-time employee, you will have access to the following employer/employee paid benefits:

• Medical, Dental, Vision, 401k match, HealthJoy - a no cost medical and mental health online resource available Day 1, and much more
• Robust earned paid time off program (PTO)
• Federal Loan Forgiveness Program (available on eligible roles)
• Professional Development Support

SCOPE OF ROLE

Reporting to the Senior Manager, Revenue Cycle, the Patient Financial Specialist proactively assess patients to determine the need for financial assistance. The Patient Financial Specialist will create a welcoming, professional and efficient experience for patients. The Patient Financial Specialist will be successful in their role by creating an outstanding patient services experience.

HOW YOU’LL SUCCEED

• Proactively screen patients assess the need for authorization, identify past due balances, assist with challenges with claims and determine benefit eligibility.
• Review and audit daily reports to investigate and take action when needed by correcting coverages and balances (including denials, co-insurance, co-pays, etc.).
• Ensure thorough completion of patient registration, maintaining the accuracy of patient information, insurance coverage, and guarantor accounts.
• Perform as the subject matter expert regarding insurance coverages, including identifying correct insurance plans, hard stops in the EHR, correct filing orders, and accepted payers.
• Enroll and educate patients in financial assistance programs such as grants, sliding scale and self-pay options.
• Ensure a consistently excellent patient experience for inbound and outbound phone calls.
• Monitor the billing phone line, specialist phone line and personal extension and respond with timely outreach via phone call, email, or other electronic communications.
• Demonstrate a high level of understanding surrounding patient balances – including understanding of why the patient has a balance, options to resolve the balance, and correct any errors that may have been made.
• Make appropriate linkages to resolve complex financial issues impacting care delivery.
• Demonstrate a high level of problem-solving expertise and assist with denied claims; including explaining why the claim was denied, if there are any actions that need completed, and offering additional options for assistance in resolving the account.
• Function as the subject matter experts in Medicare, Medicaid, sliding scale, and grant programs.
• Demonstrate efficiency through multi-tasking and organization to ensure all daily tasks are consistently completed.
• Participate in all assigned staff meetings and staff development programs.
• Other duties as assigned.

KNOWLEDGE & EXPERIENCE

• High School Diploma or equivalent required.
• 3-5 years’ of experience working with payer sources, such as Medicare, Medicaid and Commercial insurances required.
• 2-3 years’ experience in medical billing and/or coding preferred.
• Proficient computer skills with a working knowledge of Microsoft Suites required, such as Excel, Word, Teams, Outlook.

WORKING CONDITIONS

• Work is normally performed in a typical interior/office/clinical work environment.
• While hours of operation are generally standard, flexibility to work evenings and extended hours may be required.
• Requires periods of sitting, standing, telephone, and computer work.
• Hearing: adequate to hear clients or patients in person, over the telephone or through telehealth technology.
• Speaking: adequate to speak to clients or patients in person, over the telephone or through telehealth technology.
• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
• Physical effort required: occasional lifting and carrying items weighing up to 15 pounds, unassisted.
• Possible exposure to blood borne pathogens while performing job duties.
• Frequent bending, reaching, and repetitive hand movements, standing, walking, squatting and sitting, with some lifting, pushing and pulling exerted regularly throughout a regular workday.
• Sufficient dexterity to operate a PC and other office equipment.

This Success Profile is not an exhaustive list of all functions or requirements that you may be required to perform; you may be required to perform other job-related assignments as requested by your supervisor or the company. You must be able to perform the essential functions of the position satisfactorily; however, if requested, reasonable accommodations may be made to enable you to perform the essential functions of this job, absent undue hardship. Signature Health may revise this Success Profile at any time, with or without advanced notice.

All employees of Signature Health are required to comply with the Signature Health Annual Influenza Vaccination Policy. This policy requires employees to obtain an annual flu vaccination. A medical and/or religious exemption may be submitted for review by the Signature Health Review Committee. Exemption requests are not guaranteed to be approved. Signature Health is a drug-free workplace. After receiving a conditional job offer, all applicants must successfully pass a pre-employment drug screen.