[Hiring] Patient Financial Specialist @Prisma Health

Role Description

Understands the overall organizational goals for timely and appropriate resolution of accounts. 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.

• Performs in-depth demographic and financial assessments, generally at the bedside, and analyzes to determine an appropriate payor source.
• Follows up from the assessment, which may include assisting the patient and contacting outside agencies such as Vocational Rehabilitation, Department of Health and Human Services, Social Security Administration, and others.
• Works collaboratively with Social Work and Outcomes Management to support their initiatives with ensuring the most appropriate continuum of care for the patient.

This position is 100% REMOTE.

Qualifications

• High School diploma or equivalent OR Post High School Diploma.
• 3 years - Health Care Revenue Cycle Experience (such as Billing, Collections, and/or Customer Service).
• Bachelor's degree and 3 years experience in a service industry may be substituted for the above education/experience requirements.

Requirements

• Interviews patient and/or patient's representative (in accordance with HIPAA Guidelines) to obtain complete and accurate demographic and financial information.
• Possesses and demonstrates knowledge of computer systems and financial counseling processes.
• Exercises judgment 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.
• 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 relevant departments.
• Coordinates and delegates referrals to the Department of Health and Human Services for application completion.
• Maintains superior revenue cycle knowledge through ongoing review of governmental, managed care, and other third party payor regulations and guidelines.
• Contacts Social Security Administration and makes appointments for patients as needed.
• Completes special projects related to the revenue cycle as assigned.
• Exercises superior judgment in the elevation and determination of issues to be escalated to the appropriate management (internal/external).

Company Description

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.