financial coord-spp

Summary

Position Summary: In an effort to secure reimbursement for the Hospital, verifies insurance benefits and obtains pre-certification or authorization for Hospital admissions and outpatient procedures. Essential Functions: Obtains Insurance Info Obtains and verifies insurance information provided by the patient, various Hospital departments, and physician offices. Tasks: Manage schedules thorugh timely communication with all customers. Manage the pre-registration of accounts for eligibility, benefits, authorization, proper notification practices, and in accordance with CMS and patient access protocols. Contacts the insurance company to determine insurance eligibility and benefits. Enters all information provided by insurance into Hospital system notes. Updates billing information to reflect the correct insurance address to insure proper billing and timely collection activity. Coordinates communication of financial clearance to all customers. and serves as the communication liasion between the hospital and the patient. Collects out-of-pocket amounts and refers patients with an inability to pay to the appropriate resources. Secures Authorization Obtains referrals, authorization, or pre-certification number if necessary to insure reimbursement in a timely fashion and avoid loss of revenue. Tasks: Contacts physician's office if clinical information needs to be called into the insurance pre-certification department. Documents Hospital system with all information gathered from insurance and/or physician office. Scans proof of referral, authorizations, ID cards, insurance cards, and/or pre-certification screen-prints and faxes in chronological order to assist in the appeals process. Account Resolution Contact patients prior to visit, while in-house, or post discharge to discuss resolution of estimated total liability. This is accomplished by phones calls, written correspondence and floor visits

Educational Requirements:

1-3 years of experience

Additional Information

As one of the largest health care providers in Maryland, with 13,000 team members, We strive to CARE BRAVELY for over 1 million patients annually. LifeBridge Health includes Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital and Grace Medical Center, as well as our Community Physician Enterprise, Center for Hope, Practice Dynamics, and business partners: LifeBridge Health & Fitness, ExpressCare and HomeCare of Maryland.

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