GENERAL SUMMARY:

Provides financial guidance to patients regarding insurance coverage, cost estimates, payment options, and financial assistance programs. Ensures patients are financially cleared prior to services and supports the revenue cycle through accurate documentation and timely collections. Mentors and works closely with the Patient Financial Associates to ensure financial assistance applications are completed and include all the necessary documents. Works with patients on any deficiencies.

PRINCIPAL JOB FUNCTIONS:

1. Commits to the mission, vision, beliefs and consistently demonstrates our core values.

2. *Ensures timely collection of payment on assigned accounts in accordance with policies and procedures.

3. *Researches, verifies and updates, as necessary, the accuracy of patient demographic and insurance information, prior correspondence, contacts and payments.

4. Assists patients with Medication Assistance.

5. Completes and submits Medication Assistance applications.

6. Notifies patients when medications have arrived.

7. Acts as a liaison between patients and prescription companies.

8. Calls patients to re-enroll with Medication Assistance.

9. *Verifies insurance eligibility, benefits, and pre-authorizations.

10. *Explains patient financial responsibility, including deductibles, copays, and out-of-pocket costs.

11. *Provides cost estimates and establishes payment arrangements.

12. *Assists patients with financial assistance applications and charity programs.

13. Mentors and provides support to the Patient Financial Associates.

14. Assists with cashiering functions by receipting money received for patient payments on hospital, non-patient services and general fund deposits as needed.

15. Follows health system protocols in communicating and releasing patient protected health and financial information.

16. Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.

17. Participates in meetings, committees and department projects as assigned.

18. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk “*").

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:

1. Maintains role competencies as required for the department.

2. Knowledge of patient accounting operations and quality improvement techniques.

3. Knowledge of credit and collection practices, third party payer regulations, and Joint Commission regulations.

4. Knowledge of federal regulations including COBRA, Medicare, Medicaid, and Bryan Medical Center’s Corporate Compliance Plan.

5. Knowledge of computer hardware equipment and software applications relevant to work functions.

6. Ability to practice proper body mechanics to ensure personal and customer/patient safety.

7. Ability to communicate effectively both verbally and in writing.

8. Ability to perform crucial conversations to support patients under financial stress with understanding and respect.

9. Ability to establish and maintain effective working relationships with all levels of personnel and medical staff.

10. Ability to problem solve and engage independent critical thinking skills.

11. Ability to maintain confidentiality relevant to sensitive information.

12. Ability to prioritize work demands and work with minimal supervision.

13. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Associate’s degree in business or accounting-related field preferred.

Minimum of two (2) years’ experience in healthcare billing, insurance verification, patient financial services, patient access, or social work (counseling) required. Knowledge of medical terminology/CPT and coding skills preferred. Must be 19 years of age to witness legal consents.

OTHER CREDENTIALS / CERTIFICATIONS:

Certification from a Healthcare accredited association such as HFMA, AHIMA, AAHAM, or AAPC preferred.

PHYSICAL REQUIREMENTS:

(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)

(DOT) – Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.