Financial Verification HIM Ambassador (Per Diem)

NorthBay Health; Fairfield (CA); On-site; USD 60,000 - 90,000; Full time

Job summary

NorthBay Health in California seeks a Financial Verification Ambassador to accurately pre-register and complete financial analysis for inpatient admissions, outpatient procedures, and ambulatory services, by scheduling, verifying eligibility, benefits, and arranging payment responsibilities.

You will secure required authorizations, coordinate with case management to support reimbursement, educate patients on coverage details, and collaborate with the Patient Access and Financial Counseling teams

Qualifications

• Associate degree preferred and certification within 12 months of hire.
• 5+ years customer engagement in a healthcare revenue cycle environment.
• Excellent oral and written communication; ability to articulate thoughts clearly.
• Experience with insurance health plans and billing regulations; phone-based service preferred.
• Knowledge of Medi-Cal, Medicare, Managed Care, Indemnity and Workers' Compensation eligibility and benefit coordination.

Responsibilities

• Pre-registers inpatients, outpatients, and ambulatory services; schedules appointments and procedures.
• Verify eligibility, benefits, coverage limitations, and collect or arrange payment responsibilities.
• Obtain necessary authorizations and coordinate with case management for utilization review requirements.
• Explain coverage details to patients, including coordination of benefits, deductibles, co-pays and balances.
• Maintain professionalism, confidentiality and effective written/oral communication; support QA/Training and quality improvement initiatives.

Skills

Customer service

Communication skills

Healthcare revenue cycle

Insurance knowledge

Phone-based support

Education

Associate Degree

Patient Access Revenue Cycle Certification

Job description

Department Purpose Statement

Our purpose is to create a positively memorable and inspiring “Wow” experience for each and every customer we serve, each and every time we have the opportunity to serve them. We distinguish ourselves by our ability to listen and empathize with others and by the extraordinary efforts we make to deliver uncompromising levels of service. We are here to guide our customers, both patients and their families, through a seamless healthcare experience that provides tailored assistance and education that is responsive to their individual needs and expectations. Our goal is to continue to value and delight our patients with experiences that nurture powerful customer relationships that will last a lifetime. We take accountability for every aspect of our patients’ experience and continuously strive through every interaction we engage in to prove ourselves as stewards of the NorthBay way.

Job Description

At NorthBay Health the Financial Verification Ambassador accurately, efficiently and timely pre-registers, and completes financial analysis activities for all scheduled and unscheduled inpatient admissions, outpatient procedures, and ambulatory services by scheduling appointments and procedures, verifying eligibility, benefits, coverage limitations, and collecting and/or making arrangements for patients to meet deductible/share of cost and co-payment responsibilities.

Responsible for obtaining all necessary authorizations as well as coordinating with case management to meet any reporting/utilization review requirements to ensure maximum reimbursement. Conducts educational conversations with patients explaining the details of their coverage eligibility and benefits, including but not limited to information on coordination of benefits, the status of required authorizations, estimated charges, outstanding deductibles, share of cost, co-pays and out-of-pocket obligations and outstanding balances from previous visits.

Takes initiative to resolve patient issues to the best of your ability and when required, refer patients to other members of the Patient Access or Financial Counseling team, as well as other departments within the health system as appropriate. Maintains and promotes an attitude of professionalism and empathy as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self and consistently demonstrate excellent oral and written communication skills. Assists the QA/Training Coordinator and the Exceptional Experience Coaches with training and department quality improvement projects. Consistently meets or exceeds department expectations for productivity, financial stewardship and patient satisfaction metrics.

Qualifications

• Associate Degree preferred.
• Patient Access and/or Revenue Cycle relevant certification from a nationally recognized healthcare credentialing organization required within 12 months of hire.
• Five or more years of customer engagement experience in a healthcare revenue cycle environment required.
• Excellent oral and written communication skills with the ability to effectively articulate thoughts into a useful and meaningful discussion. Intensive experience with insurance health plans and knowledge of billing regulations required and experience with phone-based customer service is strongly preferred.
• Differentiation of the unique characteristics of Medi-Cal, Medicare, Managed Care, Indemnity and Workers Compensation including eligibility requirements and benefit coordination.
• Impact of completeness and accuracy that the registration/admission process has on successful claims processing and receipt of payment.
• Impact of completeness and accuracy that the registration process has on the delivery of patient care.