Patient Accounts & Insurance Coordinator

RIH Rhode Island Hospital; Rhode Island; On-site; USD 32,000 - 52,000; Full time

Job summary

Brown University Health seeks a detail-oriented clerk to support patient registration, billing and welfare eligibility at Rhode Island Hospital in Providence. You will collect demographics, verify insurance, discuss balances, and determine eligibility for free services while guiding patients through payment options.

You will document insurance information in PMAS, obtain authorizations, and register patients for clinics and procedures in ambulatory settings, supporting billing and revenue cycles

Qualifications

• A level of knowledge generally obtained through completion of High School with additional math and computer courses.
• Well developed interpersonal and communication skills in order to obtain patient information and deal effectively with the public at point of contact.
• Persuasive collection techniques. Ability to tactfully set payment arrangement terms and collect money.
• Full knowledge of third party health insurance claims processing, coverage and documentation requirements.
• Math skills and the ability to operate on-line computer terminal.
• Acquired knowledge of Accounting Department patient billing systems.

Responsibilities

• Competes Hill-Burton application when patient lacks evidence of adequate health insurance coverage, according to established criteria for provision of uncompensated hospital services.
• Requires patient to sign statement of financial responsibility.
• Assists patient to apply for welfare coverage, if no coverage is obtained or if can not pay.
• Determines eligibility for Rhode Island Hospital free service for clinic visit only, using sliding scale and based on established guidelines for same.
• Advises Senior Patient Advocate of patients lacking health insurance coverage and/or sources of income sufficient to reimburse Hospital for services rendered.
• Completes documentation required to initiate commercial insurance, Workers’ Compensation and/or CHAMPUS claims.
• Verifies third-party insurance plan numbers and benefit level.
• Documents all information obtained in PMAS accounting notes.
• Contacts insurance carrier when necessary to obtain treatment authorization and co-payment information.
• Obtains authorization for treatment from health maintenance organizations, verifying coverage as needed.
• Discusses existing Hospital account balances and arranges payment schedule for same.
• Requests evidence of coverage or requested payment ranging from partial to full cost for clinic visit or entire treatment series.
• Requires completion of Financial information to make payment arrangements when patient unable to pay entire amount.
• Upon determination that a liability claim exists, completes lien form and notes in PMAS accounting file.
• Collects cash/credit card payment for Outpatient/Emergency/Trauma services when possible.
• Posts payments to specific general ledger account.
• Prepares bank deposit for pickup by cashier twice daily.
• Determines priority of health insurance coverage.
• Registers all patients on-line by entering appropriate data to computer system via terminal.
• Embosses identification card in order to initiate or update patient Hospital record.
• In ambulatory registration, registers all patients for PAC Operating Room, clinics and ancillary areas.
• Takes APC Operating Room bookings and initiates all charge vouchers for out-patient procedures in Emergency Department registration, notifies appropriate security agency of emergency treatments resulting from assaults, gunshot wounds, animal bites, accidents and the like, according to Rhode Island State Department of Health regulations.
• Follows up on third-party documentation from Private Physician’ offices and other hospital off-hour ancillary areas.

Skills

Interpersonal skills

Communication skills

Persuasive collections

Math skills

Online data entry

Education

High School diploma

Tools

PMAS accounting

Billing software

Job description

Brown University Health seeks a detail-oriented clerk to support patient registration, billing and welfare eligibility at Rhode Island Hospital in Providence. You will collect demographics, verify insurance, discuss balances, and determine eligibility for free services while guiding patients through payment options.

You will document insurance information in PMAS, obtain authorizations, and register patients for clinics and procedures in ambulatory settings, supporting billing and revenue cycles