Revenue Cycle Financial Specialist

2 weeks ago

Lorain, Ohio, United States Ensemble Health Partners Full time

Thank you for considering a career at Ensemble Health Partners.

Ensemble Health Partners is a premier provider of technology-driven revenue cycle management solutions tailored for healthcare systems, including hospitals and associated physician groups.

We deliver comprehensive revenue cycle solutions alongside a wide array of targeted point solutions to clients nationwide.

Our mission is to maintain community health by ensuring the vitality of hospitals. We understand that healthcare demands a personal touch, and we are committed to making every interaction meaningful. This is why our team members are the cornerstone of our organization. By empowering them to question the norm, we believe they will drive the change.


The Opportunity:

Career Opportunity Highlights:
Bonus Incentives
Paid Certifications
Tuition Reimbursement

The Patient Financial Advisor (PFA) role is pivotal in reviewing benefits and collecting liabilities from hospitalized patients (inpatient, observation, or bedded outpatient), including any outstanding balances throughout Ensemble Health Partners.

This position also encompasses essential reporting and auditing responsibilities, requiring a thorough understanding of the client's financial assistance (FA) policy to facilitate the FA application process, clarify its details, and address any inquiries.

The PFA is tasked with executing these functions while upholding the mission of Ensemble Health Partners and adhering to all regulatory compliance standards.


Key Responsibilities:


• Gather patient insurance and financial details to establish estimates and collect on anticipated patient liabilities (including copays, deductibles, co-insurance, and outstanding balances after financial assistance has been applied) while achieving assigned daily point of service (POS) collection targets.

• Notify recently discharged (within 7 days) hospitalized patients who have not settled their estimated liabilities, including documenting attempts within account notes.

• Collaborate in daily cashiering duties as assigned by the client, including daily cash reconciliation and deposit activities.

• Manage flat-rate contracts, bundled services, and applicable self-pay options.
• Facilitate communication with key stakeholders regarding case statuses and escalations.

• Work alongside Case Management and/or Utilization Management to complete regulatory forms, including but not limited to Hospital Inpatient Notices of Non-Coverage (HINNs) and Lifetime Reserve Day (LTR) declinations.

• Monitor and address missed collection opportunities, striving for process enhancements and follow-up, making at least three documented attempts daily to reach out to patients listed in an inpatient status.

• Maintain Client and/or Ensemble-specific work queues pertinent to the PFA role, including unbilled edits.

• Complete various follow-up reports as assigned, including accounts requiring next-day verification and denial root cause analysis.

• Manage communications with patients unable to make payments during their hospital stay.
• Ensure all necessary registration-related consents/forms are completed at or after patient admission.
• Develop and submit escalations to the CFO regarding uncollected estimated liabilities in accordance with existing financial clearance policies.

• Assist eligibility specialists in verifying insurance information, including Medicaid and charity processing, conducting comprehensive payor searches for secondary coverages, and providing education on coordination of benefits.

• Work daily queues to complete, update, and resolve any unbilled accounts as required and assigned.

Desired Experience:
1 to 3 Years

Preferred Knowledge, Skills, and Abilities:
• Basic understanding of the following based on prior experience:
• Labor & Delivery benefits
• Understanding and explaining Explanation of Benefits (EOBs)
• Grants and research
• Healthcare Sharing Ministry coverages
• Billing and backend processes
• Defense Enrollment Eligibility Reporting Systems (DEERS) process
Join an award-winning company recognized for excellence.

Employee Benefits:

We provide a comprehensive benefits package designed to support the physical, emotional, and financial well-being of you and your family, including healthcare, time off, retirement, and wellness programs.


Our Culture:

Ensemble is a workplace where associates can excel and be their authentic selves. We prioritize people, fostering a culture rooted in collaboration, growth, and innovation.


Professional Development:

We are committed to your professional growth. Each associate will earn a relevant professional certification and can benefit from tuition reimbursement.


Recognition:

We offer quarterly and annual incentive programs for all employees who consistently exceed expectations and contribute to the company's success.

Ensemble Health Partners is an equal employment opportunity employer.

We uphold a policy of non-discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information, or any other basis protected by applicable federal, state, or local laws.

Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.

If you require accommodation in the application process, please reach out.

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