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Patient Account Specialist

2 months ago

Baton Rouge, Louisiana, United States Franciscan Missionaries of Our Lady Health System Full time
Job Overview

At Franciscan Missionaries of Our Lady Health System, we provide more than just employment in the healthcare sector. We present career paths for individuals who feel called to utilize their skills and talents as part of our compassionate mission. As a faith-based healthcare provider, we aim to foster a culture of healing. Here, you have the unique opportunity to contribute to meaningful work by assisting those in need within our community every day.

Position Summary

Shifts available from 8:00am to 4:30pm or 7:00am to 7:00pm. The Healthcare Financial Consultant is responsible for evaluating uninsured patients for Medicaid and financial aid; guiding patients through the completion of Medicaid and financial assistance applications; overseeing the Medicaid eligibility/application process; collecting patient responsibilities for unscheduled insured inpatients and observation patients; and employing critical thinking skills to identify the most suitable resources available to assist patients in need. The Healthcare Financial Consultant will possess comprehensive knowledge of all facets of the department's processes, from registration through to billing. This role requires familiarity with medical insurance and collections, as well as assisting in resolving issues related to a patient's capacity to pay for services. The Healthcare Financial Consultant reviews available funding sources for which the patient qualifies and addresses inquiries regarding patient accounts, explaining payments made. This position expects the individual to work autonomously, manage their case load effectively, and require minimal supervision.

Qualifications and Skills
  • Minimum of 1 year experience in financial services, insurance, or billing/patient accounts
  • Bachelor's Degree required
  • Proficient clerical and computer skills; must demonstrate sound judgment, analytical abilities, and communication skills necessary to achieve objectives in often sensitive environments. Familiarity with various funding sources and eligibility criteria is essential, along with a thorough understanding of hospital billing processes.
Key Responsibilities
  1. Customer Service
    1. Educates, screens, and assists patients lacking valid insurance coverage to enroll in third-party eligibility programs. Conducts interviews with qualified patients to explore potential funding sources, including Medicaid and financial assistance programs. Executes all related functions promptly and accurately.
    2. Informs patients during interviews about relevant policies such as point-of-service collection, payment options, and financial assistance. Follows up with patients and the Division of Medicaid to ensure proper completion of applications and submission of all necessary documentation. Remains updated on applicable statutes, regulations, and compliance policies affecting assigned tasks.
    3. Submits Medicaid applications accurately and on time.
    4. Meets with self-pay patients to obtain valid insurance coverage, if applicable, and reviews prior account information to secure insurance coverage. Communicates updates to departments regarding patient accounts.
    5. Consistently interacts with sensitivity towards patients and their families, responding to individual needs. Exhibits exceptional customer service and communication skills, effectively calming distressed patients and their families.
    6. Acts as a resource for patients and their family members to ensure access to all available funding options.
  2. Critical Thinking
    1. Evaluates patient financial conditions based on interviews and inputs data into the financial counseling system. Documents all communications and related activities in the appropriate sections of each patient's account using suitable tools and terminology. Updates patient accounting information systems accordingly.
    2. Responsible for calculating patient out-of-pocket expenses and collecting those amounts for unscheduled inpatient and observation admissions with insurance coverage. Applies effective critical thinking skills and a professional approach in handling these collection situations.
    3. Maintains comprehensive records for all patients applying for indigent or financial assistance, including applications, proof of income, acceptance/denial letters, and any other relevant documentation.
    4. Verifies and ensures all accounts are prepared for routing for charity or billing with adequate supporting documentation within established time frames.
    5. Demonstrates the ability to work independently, pay attention to detail, and complete tasks in a timely and accurate manner. Operates in a self-directed manner with minimal supervision.
    6. Manages multiple responsibilities simultaneously and prioritizes tasks effectively.
    7. Identifies trends that may indicate potential issues and alerts supervisors or management accordingly, playing a key role in initiating solutions.
  3. Interpersonal Relations
    1. Collaborates closely with Case Management on a daily basis regarding notifications of active Medicaid coverage, authorizations, and changes to plans; obtains necessary authorizations and forwards them to Utilization Management upon receipt.
    2. Maintains regular communication with Utilization Management, Business Office, patient Registration, Medical Records, Ancillary departments, various third-party agencies, HMO/PPOs, patients, their families, physician offices, and other external entities.
    3. Actively participates in and encourages others to adopt creative and innovative approaches to accomplish tasks.
  4. Additional Responsibilities
    1. Performs other duties as assigned.