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Patient Financial Associate

3 months ago

Washington, Washington, D.C., United States MEDSTAR HEALTH Full time
Under the general supervision of the Director of Revenue Cycle Improvement and in close coordination with Clinical Nurse Coordinators and financial staff, coordinates the financial aspects of patients' cars. Identifies and obtains information to ensure that the financial needs of the department and affiliated clinic patients are properly met and that information is properly captured and shared in order to maximize reimbursement to GUH in support of care for the patients. Serves as a departmental expert in reimbursement rules and acts as an advocate for the patient on financial issues, while maintaining excellent customer service levels. These functions are performed in accordance with all applicable laws and regulations and Georgetown University Hospital's philosophy, policies, procedures, and standards.
Education
  • Associate's degree required
  • Bachelor's degree preferred
Experience
  • Experience in customer service oriented environment required and
  • Experience in hospital or physician registration, insurance verification and/or medical billing required
Licenses and Certifications
  • N/A
Knowledge, Skills, and Abilities
  • Excellent oral and written communication skills, excellent customer service skills, Detail oriented. Excellent organizational skills.
  • Proficiency with medical terminology, experience with basic anatomy/physiology.
  • Understanding of medical terminology, ICD-9 codes, and third-party payer procedures.
  • Knowledge of computerized registration, scheduling, and billing systems is a plus.
  • Good interpersonal and communication skills.
Obtains preauthorization, insurance verification, eligibility, basic benefits information, and approved length of chemotherapy and/or other infusion therapies treatments on all patients receiving services including diagnostic procedures associated with cancer treatment.Facilitates and/or obtains continued authorizations to patients receiving chemotherapy and other infusion therapies on the infusion unit.Tracks and maintains referral and preauthorization records for all patients and ensures that authorizations are obtained, updated, and recorded in a timely manner, such that patient care is not inappropriately delayed and that denials are minimized.Assists with facility charge entry for patients seen in the clinic in accordance with agreed-upon procedures.Reviews daily unit schedules to identify and resolve any necessary documentation needs prior to rendering care (authorizations and other financial information)Collaborates with outside referring departments for patients receiving treatments in the Infusion unit. Ensures that all necessary authorizations are performed and are in place prior to the patient's receiving treatments.Communicates with appropriate health care team members, Interacts with the Clinical nurse coordinator and other staff for a timely flow of information.Communicates effectively and maintains positive relationships with external audiences, this includes but is not limited to communicating directly with patients for clarification and follow-up purposes.Maintains records and files. Tracks all data for preauthorization.Identifies issues requiring resolution by other GUH/departmental Leadership and brings them to the administration's attention in a timely manner.Meets regularly or as needed with the clinical nurse coordinator to review clinical data required for preauthorization treatment.Acts as a resource for a financial administrator for documentation of authorization to reconcile denials.Performs other duties and responsibilities that are appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and is not to be considered all-inclusive.