Patient Financial Services Specialist

2 weeks ago

Baton Rouge, United States CareSouth Full time
Job DescriptionJob Description

SUMMARY: The Patient Financial Services Specialist is responsible for providing the patient with insurance and program education to ensure accurate information and excellent customer service. Responsibilities include collecting required patient information and verify insurance eligibility, financial status and enrolling patients in state and clinic programs (if applicable), informing the patients of any out-of-pocket (OOP) costs and /or processing payment arrangements. In addition, the Patient Financial Services Specialist will be responsible for obtaining referrals and/or authorizations for clinic services, ensuring accurate, and timely information exchange with clinical departments, and collecting data for routine reporting.


POSITION RESPONSIBILITIES:

  1. Knowledge and understanding of Employee Handbook.
  2. Carry out the meaning of the CSMD Mission and Vision statements.
  3. Practice a culture of safety to reduce or prevent risk of injury, claims, loss or liability by utilizing the Risk Management and Infection Control Plan.
  4. Perform responsibilities with a high-quality standard to yield improved compliance, quality, and patient outcome measures by adhering to the Quality Improvement Plan.
  5. Be present and ready for work as scheduled.
  6. Attend in-service trainings, departmental meetings, and community events.
  7. Work cohesively with team members.
  8. Greets patients, visitors, and staff in a courteous, friendly, and professional manner.
  9. Conducts interviews with patients and / or family members.
  10. Obtains relevant patient demographic information (i.e. address, phone numbers, insurance, etc.) and service information upon each visit.
  11. Verifies insurance coverage and benefits via online access or by phone in advance of a patient's appointment.
  12. Explains benefits to patients as well as staff, as applicable.
  13. Obtains prior authorizations as applicable.
  14. Assists eligible patients with completing Sliding Fee Applications.
  15. Updates patient demographic and insurance information in the EMR as applicable.
  16. Transmits benefits applications to patients via email upon request to expedite verification processes.
  17. Set up arrangements / monthly installment plans for patients to payoff balances within the guidelines of CSMD collection policy.
  18. Verify insurance coverage and benefits via online access or by phone in advance of a patient's appointment.
  19. Provide patients and staff with insurance and clinic based financial program education through explanation of benefits and eligibility requirements.
  20. Send benefits applications to patients via email upon request to expedite verification processes.
  21. Conduct comprehensive patient interviews to assess eligibility for third-party payer benefits and clinic-based programs.
  22. Works collaboratively with Patient Engagement team members.
  23. Refers uninsured and self-pay patients to Outreach team for assistance with health insurance enrollment. Advises self-pay patients of their medical and dental care options available and refer to outreach & enrollment specialist as needed.
  24. Assists Patient Engagement team members at satellite sites with eligibility issues.
  25. Provides backup coverage for Patient Engagement staff as needed and works collaboratively with Patient Engagement staff to provide excellent customer service to patients when answering calls and during check in and check out procedures.
  26. May perform appointment reminders and document the outcome/status in the Dentrix System, as directed.
  27. Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Ryan White program, Federal Marketplace, and other health coverage programs such as Healthy Louisiana (Medicaid and CHIP).
  28. Maintains confidentiality of patient's protected health information.
  29. Identifies areas of improvement such as workflows and policies and processes.
  30. Answers the phones as required.
  31. Performs other duties as assigned.
  32. Advises self-pay patients of their medical and dental care options available.
  33. Arranges monthly installment plans for patients to payoff balances within the guidelines of CSMD collection policy.
  34. Maintains knowledge of all programs offered by CareSouth.

REQUIREMENTS

  1. Certificate in Medical Office Administration with three years of relevant experience OR an Associate's degree in health care, accounting or related field with two years of relevant experience. Bachelor's degree preferred.
  2. Must have a strong understanding of all major health insurance carriers, knowledge and experience working within insurance companies; must have strong computer, basic math, and decision-making skills.
  3. Excellent verbal and written communication skills.
  4. Must have exceptional interpersonal communication skills.
  5. Must be able to effectively resolve conflicts.
  6. Demonstrated professionalism in dealing with confidential and sensitive patient information. Comfortable discussing financial matters and asking for/requesting payment on past due accounts.
  7. Detail-oriented with ability to effectively prioritize tasks in a fast-paced environment
  8. Must have superior communication skills (reading/written/verbal) and organizational skills.
  9. Exhibit a high level of courtesy, tact and poise with interacting with patients, co-workers, other internal customers, visitors and healthcare professionals.
  10. Cash management experience in order to process and request payments.
  11. Excellent computer skills, experience with Electronic Health Record system preferred.
  12. Able to work independently and as part of a team.
  13. Ability to sit for long periods and communicate over telephone while using computer.
  14. Performs all job responsibilities in full compliance with all applicable laws, rules, regulations, policies and procedures.

SUPERVISES

N/A


TRAINING

Relias Track A Non-Clinical

Relias CareSouth Onboarding


PERFORMANCE MANAGEMENT EVALUATION TYPE

Patient Engagement


APPLICATION PROCEDURE

Please submit a completed employment application found at www.caresouth.org/jobs. CareSouth is an EOE.


CLOSING: This announcement will remain open until June 28, 2024.

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