Public Resource Specialist - Sel Pay Rev Cycle Ops - Sharp Memorial Hospital - Day Shift - Full Time

Sharp HealthCare; San Diego (CA); Vor Ort; USD 37.000 - 52.000; Vollzeit

Zusammenfassung

Sharp HealthCare in San Diego, CA seeks a detail-oriented professional to analyze individuals' financial status for public funding eligibility and help underinsured patients secure government, commercial, and private funding for healthcare costs.

You will collaborate with physicians, social workers, and case managers to support discharge planning and educate patients on healthcare options and resources. "

Qualifikationen

• Driver's License required (CA DMV).
• HS Diploma or Equivalent required.
• 3 years experience in a health care system revenue cycle.
• Previous social work or case management experience.
• California Notary Public preferred.
• Covered CA Enrollment Counselor certification preferred.

Aufgaben

• Performs in-depth financial analysis of individuals' financial status for public funding eligibility.
• Assists the underinsured and uninsured patients in securing funding to cover healthcare costs.
• Collaborates with physicians, social workers, and case managers for discharge planning.
• Educates patients on healthcare options and resources.
• Completes required applications and supporting documents for programs (Medi-Cal, Medicaid, CMS, CMSP, SSI).
• Manages field visits, reports mileage/expenses daily, and ensures PHI safety during transport.

Kenntnisse

Driver's License

Ausbildung

HS Diploma or Equivalent

California Notary Public

Jobbeschreibung

Hours

• Shift Start Time: 8 AM
• Shift End Time: 4:30 PM
• AWS Hours Requirement: 8/80 - 8 Hour Shift
• Weekend Requirements: No Weekends
• On-Call Required: No
• Hourly Pay Range (Minimum - Midpoint - Maximum): $26.970 - $33.730 - $37.770

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Perform in depth financial analysis of individual's financial status for the purpose of evaluating the individual's eligibility for public funding. Assist the underinsured and uninsured patients in securing governmental, commercial and or private funding to cover healthcare costs. Works in collaboration with physicians, social workers, and case managers with discharge planning needs. Educates patients on healthcare options and resources.

Required Qualifications

• Driver's License - CA Department of Motor Vehicles -REQUIRED

Preferred Qualifications

• H.S. Diploma or Equivalent
• 3 Years experience in a health care system revenue cycle.
• Previous social work or case management experience.
• California Notary Public - California Secretary of State -PREFERRED

Other Qualification Requirements

• Covered CA Enrollment Counselor certification preferred.

Utilizes reliable transportation and possesses adequate personal insurance coverage. Demonstrates clean driving record in accordance with requirements of the employer DMV pull notice program and Sharp HealthCare Driver Guidelines.

Essential Functions

Client services

• Provides direction and assistance to patients requesting financial assistance.
• Demonstrates content expertise by completing applications & supporting documents for programs including but not limited to: MediCal, Medicaid, CMS, CMSP, SSI-Disability, Victim of Crimes Compensations, COBRA, and Health Care Exchange Qualified Plan Enrollment.
• Identifies all unfunded admissions and completes face to face interview and application within 24 hours of admission.
• Manages patient's expectations for assistance through effective communication and interaction.
• Performs field visits in support of the public resource application process.
• Receives a listing of locations to be visited from the Self Pay Rev Cycle Team Lead.
• Plans their daily route based on level of urgency and geographic location.
• Completes the objective listed and reports back results.
• Uses technology in the field to provide timely update and improve efficiencies.
• Ensures PHI being transported is safe by adhering to departmental guidelines.
• Reports mileage and expense reports daily.
• Ensures responsibility utilization of organization resources and technology including: mobile telephone device and/or laptop.

Collaboration and communication

• Ensures continuity of care by building relationships with Sharp affiliated and community physicians.
• Maintains open communication and feedback to maximize the use of health care resources to members of the community.
• Provides timely communication to the assigned social worker/case manager regarding the status of application.

Database and record management

• Utilizes databases managed by the Department of Health & Human Services and/or Department of HealthCare Services.
• Completes required documentation in GE/Centricity HPA application.
• Updates demographic & insurance documentation.
• Reviews supporting documentation provided by patients for accuracy.
• Ensure information submitted to databases is accurate and processed timely.
• Submits supporting documentation timely (within 24 hours) to appropriate public program.

Problem resolution

• Works in partnership with County assigned Health and Human Services Representative (HHS) to ensure timely processing and determination of all submitted applications.
• Performs a thorough follow up process on all submitted applications as required such as: identify cases for appeal opportunity, prepare appeal paperwork with patient, attend hearings; ensuring attainment of healthcare coverage and or referral to Financial Counselor.
• Liaison between patient and public resource program staff.
• Works with hospital Social Work & Case Management departments to safely discharge patients by ensuring the public resource application process is on track.
• Uses effective interviewing skills to elicit patient application for funding information.

Knowledge, Skills, and Abilities

Strong knowledge of Federal, State & County Programs preferred.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or sta