Patient Financial Coverage Specialist
6 days ago
Ensures patients have coverage for their hospital stay and facilitates financial assistance where needed.
Key Responsibilities Include:
* Obtain and verify financial information regarding patients from various reliable sources,
* Notify insurance companies and assist with obtaining necessary authorizations,
* Handles and tracks payments, special package plan agreements and financial assistance paperwork;
* Assists with obtaining Medicaid applications, alternative financing and verifying coverage from other third party payers in a variety of hospital settings.
Responsibilities:
* Secure payment for balances on inpatient and outpatient accounts in a timely and professional manner,
* Assist Supervisor and Lead with monitoring patient financial issues and audit registration regulatory forms for accuracy daily or by shift,
* Update financial and demographic information in the ADT system to ensure accuracy and compliance,
* Address complex financial issues with patients, explain HonorHealth financial policies and determine point of service amounts due,
* Collect payments and obtain signatures on all financial documents, including package plan agreements and insurance waivers,
* Assist with the application process for Medicaid coverage, working with DES office or the vendor assigned to fulfill the application,
* Monitor status of Medicaid applications and perform daily follow up on unverified and pending accounts,
* Ensure all demographic and financial information, including insurance verification and eligibility, is accurate and up-to-date,
* Monitor authorizations for through dates and update as necessary,
* Notify Case Management of patients that are likely to exhaust their Medicare days,
* Educate patients regarding their rights, obligations and policies related to financial coverage,
* Ensure accounts are secured or take necessary steps to do so,
* Perform general cashiering duties, including receiving and posting payments to appropriate patient accounts and/or general ledger account,
* Prepare receipts, daily bank deposits and batch receipts and maintain a balanced cash drawer,
* Adhere to all third party payer requirements for both government and commercial payers, such as DNV requirements, EMTALA provisions, HIPAA and reimbursement criteria,
* Keep management informed of unique situations and problem accounts, identifying opportunities to improve work processes.
Qualifications:
* High School Diploma or GED,
* 1 year related experience
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