Patient Financial Team Lead - Patient Access Medicaid at Kettering Health Network – Kettering, Ohio

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.

Patient Financial Advocate Specialist

This individual is responsible for pre-screening and enrolling self-pay (uninsured and underinsured) patients for external financial assistance programs, with a primary focus on Medicaid. This individual is also responsible for assisting patients in the process of completing financial assistance applications, educating them about their financial responsibility, and helping them identify a path toward resolving their balances. This role involves communicating with patients both in person and over the phone, and requires a high level of customer service

1. Pre-screens uninsured and underinsured patients to identify potential financial assistance opportunities.
2. Assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs.
3. Ensures financial assistance applications are accurately filled out and complete before approval.
4. Staff coverage at other Kettering Health hospital facilities, when needed
5. Works in conjunction with on-site state social worker or outside eligibility vendor to assist and complete the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility.
6. Initiates comprehensive interviews to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs.
7. Provides patients with personalized financial assessment-based KH financial program guidelines, Insurance coverage and estimated patient liability.
8. Initiates payment arrangements, collect patient liability after financial assistance has been determined and applied.
9. Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility.
10. Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.)
11. Coverage at other Kettering Health hospitals, as needed.

Minimum Education

• High school diploma or GED required
• At least two years of appropriate work experience that would indicate a high level of communication skills and organizational ability.

Minimum Work Experience

• Financial counseling, eligibility screening, and/or Medicaid application processing experience strongly desired
• Prior experience performing community outreach preferred
• Familiarity with statutes and regulations that can impact financial conversations

Required Skills

• Broad knowledge of government Advocate programs, guidelines, and application procedures -
• Strong written and verbal communication skills
• Ability to effectively translate medical and administrative language into more familiar terminology - Strong attention to detail
• Ability to comply with procedural guidelines and maintain confidentiality