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Interprets and applies WVUH and UHA financial policies to make appropriate financial decisions and payment arrangements to ensure the financial viability of WVUH. Prepares and presents fee estimates to current and potential patients. Provides financial education regarding benefits to patient to assist in understanding their personal financial liability. Demonstrates the ability to assertively pursue necessary information and to function independently to secure financial resolution on accounts. Projects a mature problem-solving attitude while dealing with interpersonal conflict, dissatisfied patients and time demands. Maintains knowledge of revenue cycle operations, third party reimbursement, local/state/federal regulations and medical terminology. Knowledge will include at minimum, all aspect of payer relations, claims adjudication, contractual claims processing and general reimbursement procedures. Uses excellent customer service, written and oral communication skills.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1.High school graduate or equivalent

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1.Two years' experience in a healthcare setting

2.Typing speed of 25 words per minute

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1.Interviews patient who is referred for financial counseling in person or via the telephone to determine financial counseling needs and to help formulate a plan for financial resolution

2.Staff will use CPT codes to calculate the estimated procedure cost

3.Based on information provided by the patient an initial determination will be made if the patient has adequate benefits or qualifies for Medicaid, special programs or payment arrangements based on federal, state and hospital policy

4.Education will be provided to patient on their benefits, patient liability and/or the process for applying for Medicaid, completion of the financial statement and payment alternatives

5.Informs patients of hospital and clinic billing practices/policies and their rights and responsibilities regarding payments

6.Insured patients who are responsible for a balance after insurance will receive a preliminary financial overview and will be assisted in completion of the financial statement if necessary for financial resolution

7.Review completed financial statements and makes a determination based on hospital policy if the patient qualifies for a payment arrangement and documents in the registration/billing systems

8.Works with specialty departments to establish appropriate financial arrangements for elective services

9.Identifies and accurately resolves potential patient account issues for WVUH and UHA billing departments

10.Resolves billing questions for patients who present to the Inpatient, Chestnut Ridge or Physician Office Center patient services area

11.Monitors daily reports to identify large dollar account balances and private pay patients that need resolution

12.Refers patients to local, state and/or federal agencies for assistance

13.Displays an understanding of third-party payor regulations related to managed care, denials and reimbursement issues

14.Has a working knowledge of current hospital contracts with third-party payors

15.Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing. Obtains and scan patients insurance/medical cards and driver's license into the registration system.

16.Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems

17.Balances daily receipts and cash drawer for patient payments, prepares and delivers deposit bag to cashier's office

18.Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers)

19.Maintains registration accuracy threshold of 98% as identified in audit processing

20.Initiates auto accident liability coverage. Identifies all patients involved in an auto accident and obtains all pertinent information regarding medical or non-fault liability and documents in registration/billing systems.

21.Initiates ERSD (end stage renal disease) screening. Identifies ESRD patients and obtains all pertinent information regarding coverage by SSI and documents in the registration/billing systems.

22.Initiates Veterans Administration eligibility screening. Identifies all VA eligible patients and coordinated admission/treatment with AV and documents in the registration/billing systems.

23.Initiates Black Lung SSI screening. Identifies all patients covered under Black Lung and documents in the registration/billing systems.

24.Initiates Workers Compensation screening. Accurately identifies all patients seeking treatment for work related injuries. Assists in completion of appropriate paperwork and documents in the registration/billing systems.

25.Initiates MSP (Medicare secondary screening). Obtains all information regarding MSP. Documents in registration/billing system all information required on the MSP form.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift

2.Must be able to sit for extended periods of time

3.Visual acuity must be within normal range

4.Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects

5.Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.Office type environment

2.Patient care environment

SKILLS & ABILITIES:

1.Ability to accurately utilize applicable computer software and equipment for access processing

2.Demonstrates ability to follow established computer down time procedures.

3.Must have reading and comprehension ability

4.Must be able to communicate effectively

5.Must be able to read and write legible in English

6.Excellent oral and written communication skills

7.Working knowledge of computers

8.Basic knowledge of medical terminology

9.Basic knowledge of third party payors preferred

10.Basic knowledge of time of service collection procedures preferred

11.Basic knowledge of business math preferred

12.Basic knowledge of ICD-9 and CPT coding preferred

13.Excellent customer service and telephone etiquette

14.Must demonstrate the ability to use tact and diplomacy in dealing with others

Additional Job Description:

Scheduled Weekly Hours:
40

Shift:

Exempt/Non-Exempt:
United States of America (Non-Exempt)

Company:
STJ St. Joseph's Hospital

Cost Center:
545 STJ Patient Access

Address:
1 Amalia Drive

Buckhannon

West Virginia

WVU Medicine is proud to be an Equal Opportunity employer. We value diversity among our workforce and invite applications from all qualified applicants regardless of race, ethnicity, culture, gender, sexual orientation, sexual identity, gender identity and expression, socioeconomic status, language, national origin, religious affiliation, spiritual practice, age, mental and physical ability/disability or Veteran status.

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