Financial Resource Coordinator

St. Joseph’s/Candler Health System; Savannah (GA); Hybrid; USD 41,000 - 62,000; Full time

Job summary

St. Joseph’s/Candler Health System seeks a Financial Resource Coordinator to coordinate insurance benefits, verify coverage, and assist patients with matched programing and coverage opportunities.

You will educate patients on benefits, provide treatment estimates, and collect payments while collaborating with oncology, OB-GYN, and infusion services to obtain precertification. The role involves self-pay processes, including screening for coverage eligibility, applying for assistance programs, and

Qualifications

• 1-2 years hospital financial counseling or healthcare customer service experience.
• Experience with insurance verification and benefits, and understanding medical billing and authorization processes.
• Knowledge of Medicaid/Medicaid newborn processes and patient financial navigation is a plus.

Responsibilities

• Answer inquiries about accounts, balances, referrals, appointments and insurance in a courteous, timely manner.
• Verify insurance coverage, determine patient responsibility, establish payment plans and collect balances due.
• Identify patients needing financial assistance and submit applications to patient assistance programs.
• Communicate with departments to complete precertification and authorization processes.
• Maintain accurate records of payer requirements and update staff on authorization statuses.

Skills

Customer service

Communication

Insurance verification

Billing basics

Payment collection

Education

Bachelor's degree - Preferred

Job description

• System - Patient Financial Solutions Center

The Financial Resource Coordinator (FRC) will be responsible for coordinating insurance benefits, verifying assigned patients have coverage and approval for services, and assisting patients in applying for matched programing and coverage opportunities. The FRC will contact and educate patients about their insurance benefits, providing treatment estimates, and collecting patient payments. FRC’s work closely with SJC’s specialty care teams including but not limited to Oncology, OBGYN, and Infusion therapy to ensure precertification is obtained for ordered treatments, patient’s benefits are verified, and patients are aware of their financial responsibility. The FRC is responsible for all processes related to self-pay patients including screening for coverage eligibility, providing estimates, and matching patients to assistance opportunities. The FRCs work in multiple departments within the SJ/C health care system including the cashier office at both Candler and St. Joseph's hospital, the infusion centers in Bluffton and Savannah, and the centralized billing office. Maintaining open communication with multiple health system departments, including the entire oncology service line and all associated practices, Patient Financial Services, and the Central Billing Office, is pivotal for the success of the FRC. The FRC will work under the direction of the Financial Assistance Manager.

Education

Bachelor's degree - Preferred

Experience

1-2 Years of hospital financial counseling, customer service within healthcare, medical coding and billing, prior authorization, insurance verification and benefits, registration or other related experience - Required

License & Certification

None Required

Core Job Functions

Answers telephones and screens calls in a pleasant and courteous manner, relaying accurate messages to the appropriate personnel. Assists with inquiries including account balance, referrals, appointments, and insurance appropriately and in a timely manner. Utilizes scripting and management of expectations to promote customer satisfaction. Uses available tools to identify patients needing further review. Verifies insurance coverage, determines patient responsibility amounts and explains to patient. Establishes payment arrangement and collects balances due. Adheres to and educates patients about the in and out of network policies related to the hospital and patient’s insurance benefits.

Accurately processes requests for Financial Assistance according to department guidelines. Gathers and submits applications to patient assistance programs. Effectively communicates with patient’s application statuses and needs. If additional documentation is needed, follows up with patient until received or patient is non-compliant. For uninsured or under-insured patients uses available tools to identify patients needing further review.

Politely assesses the need for a Medicaid eligibility referral. Performs Medicaid Newborn process according to department guidelines and within specified time frame. Works with other departments seamlessly to ensure the completion of this process.

Determines precertification necessity. Communicates and coordinates with insurance companies to maximize reimbursement by providing clinical information to third party payers and documenting appropriate authorization code for payers to ensure appropriate reimbursement. Review updated information from payers, Monitor web portal alerts from payer. Maintains updated files on specific payer requirements. Effectively communicates with clinical staff patient needs, requirements, and updates in authorization process and status.

Accurately receives receipts for patient payments and provides petty cash for Hospital co-workers according to policy. Assists and screen patients in person and over the phone with questions about their accounts regarding insurance, payments, balances, and financial navigation needs. Responsible for daily deposits, and balancing end of day reporting.