Patient Financial Specialist, FT, Day

Prisma Health; Greenville (SC); On-site; USD 35,000 - 50,000; Full time

Job summary

A leading health organization is looking for a Patient Access Representative to ensure optimal collection and customer service. The position involves financial assessments at patient bedside, collaborating with health services and assisting patients in securing financial aid. The ideal candidate will have mixed healthcare revenue cycle experience and excellent interpersonal skills.

Qualifications

• Three years of healthcare revenue cycle experience required.
• Education can be substituted with a Bachelor's degree and service industry experience.

Responsibilities

• Conduct patient interviews to gather accurate financial information.
• Monitor high dollar accounts and ensure timely submission for reimbursement.
• Coordinate referrals to external agencies for financial assistance.

Skills

Interpersonal Relationship Skills

Judgment in Financial Assessments

Education

High School Diploma or Equivalent

Bachelor's Degree (in lieu of experience)

Job description

Inspire health. Serve with compassion. Be the difference.

Job Summary

Works in accordance with Patient Friendly standards consistent with policies and procedures ensuring complete, accurate, and compliant processes resulting in optimal collection and customer service performance for the organization. This includes the collection of deductibles, co-pays and co-insurances as well as payment towards accounts classified as self-pay. In depth demographic and financial assessments are performed, generally at the bedside, and analyzed to determine an appropriate payor source. Follow up from the assessment may include the need to assist the patient and contact outside agencies such as Vocational Rehabilitation, Department of Health and Human Services, Social Security Administration and others. The position works collaboratively with Social Work and Outcomes Management to support their initiatives with ensuring the most appropriate continuum of care for the patient.

Essential Functions

• All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.

• Interviews patient and/or patient's representative (in accordance with HIPPA Guidelines) to obtain complete and accurate demographic and financial information. Possesses and demonstrates knowledge of computer systems and financial counseling processes allowing the ability to follow through with all assigned accounts timely and accurately to the satisfaction of the internal and external customer. Exercises judgement in analyzing the information collected and following through to ensure the patient receives every consideration for financial assistance. Ensures elimination of all possible payor sources prior to consideration of hospital sponsorship. Communicates patient's estimated financial responsibility and requests payment prior to or at the time of service; appropriately explaining insurance terms to the patient. Receives payments and issues receipts in accordance with departmental cash handling procedures. Continually excels at the performance benchmark standards.

• Monitors high dollar accounts that represent significant exposure to ensure complete and accurate financial and demographic information necessary for timely submission and reimbursement of the account. Initiates authorization and insurance verification processes as necessary and communicates changes to those departments who need to be made aware.

• Coordinates and delegates referrals to the Department of Health and Human Services for an application to be completed. Monitors to ensure applications are secured in a timely manner.

• Demonstrates superior interpersonal relationship skills necessary for developing and maintaining positive professional relationships with patients, peers, clinical departments, payor organizations, and industry organizations.

• Maintains superior revenue cycle knowledge through an ongoing review of governmental, managed care and other third-party payor regulations and guidelines. Explores any possible payor source options such as Cobra, Liability, Worker's Compensation or other Governmental Agencies. Participates in appropriate departmental training and career developmental opportunities.

• Contacts Social Security Administration and makes appointments for patients as needed. As needed, assists the patient with the interview process and completing required forms. Facilitates the disability determination process by working with the clinical staff and disability examiner to gather information needed for a disability determination to be made. Exercises superior judgement in coordinating referrals to the appropriate outsource vendor for cases which may require additional follow up once the patient is discharged from the hospital.

• Performs other duties as assigned.

Supervisory/Management Responsibilities

• This is a non-management job that will report to a supervisor, manager, director or executive.

Minimum Requirements

• Education - High School diploma or equivalent OR post-high school diploma/highest degree earned

• Experience - Three (3) years health care revenue cycle experience (such as Billing, Collections, and/or Customer Service)

In Lieu Of

• In lieu of education and experience noted above, a Bachelor's degree and three (3) years of experience in a service industry may be considered.

Required Certifications, Registrations, Licenses

• NA

Knowledge, Skills and Abilities

• NA

Work Shift

Day (United States of America)

Location

Greenville Memorial Med Campus

Facility

7001 Corporate

Department

70019065 Patient Access-GMH Campus

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