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Financial Services Verification Specialist

2 months ago

Fairfield, California, United States NorthBay Health Full time
Position Overview

At NorthBay Health, the Financial Services Verification Specialist is responsible for accurately and efficiently pre-registering patients while conducting comprehensive financial assessments for both scheduled and unscheduled admissions, outpatient procedures, and ambulatory services. This role involves scheduling appointments, verifying eligibility, assessing benefits, understanding coverage limitations, and collecting or arranging payments to meet deductible and co-payment obligations.

The Specialist will also ensure that all necessary authorizations are obtained and will collaborate with case management to fulfill any reporting or utilization review requirements to maximize reimbursement potential.

Key Responsibilities

1. Engage in educational discussions with patients to clarify their coverage eligibility and benefits, including coordination of benefits, authorization statuses, estimated charges, outstanding deductibles, co-pays, and previous balances.
2. Proactively address patient concerns and, when necessary, refer them to other members of the Patient Access or Financial Counseling teams, as well as other relevant departments.
3. Uphold a professional and empathetic demeanor, ensuring confidentiality and maintaining a polished personal presentation.
4. Exhibit exceptional oral and written communication skills, contributing to a positive patient experience.
5. Assist the QA/Training Coordinator and Exceptional Experience Coaches with training initiatives and quality improvement projects within the department.
6. Consistently meet or exceed departmental expectations regarding productivity, financial management, and patient satisfaction metrics.

Department Mission

Our mission is to deliver a memorable and inspiring experience for every customer we serve. We set ourselves apart through our ability to listen and empathize, making extraordinary efforts to provide unparalleled service. We guide our customers—patients and their families—through a seamless healthcare journey, offering tailored assistance and education that meets their unique needs and expectations. Our goal is to foster lasting relationships with our patients through exceptional experiences that reflect our commitment to service excellence.

Qualifications

  1. Education: An Associate Degree is preferred.
  2. Certification: Relevant certification in Patient Access and/or Revenue Cycle from a recognized healthcare credentialing organization is required within the first year of employment.
  3. Experience:
    1. A minimum of five years of customer engagement experience in a healthcare revenue cycle setting is required.
    2. Strong oral and written communication skills with the ability to articulate thoughts clearly and meaningfully.
    3. In-depth knowledge of insurance health plans and billing regulations is essential, along with preferred experience in phone-based customer service.
    4. Expertise in differentiating various insurance types, including Medi-Cal, Medicare, Managed Care, Indemnity, and Workers Compensation, along with their eligibility requirements and benefit coordination.
    5. Understanding the impact of accurate registration/admission processes on successful claims processing and patient care delivery.
  4. Performance Standards: Adhere to established policies and procedures, demonstrating punctuality and attendance.
  5. Physical Requirements: Attendance is crucial for this role, and reasonable accommodations may be made for individuals with disabilities.
  6. Interpersonal Skills: Embody the NorthBay Way, demonstrating values of Caring, Communication, Collaboration, and Competence. Exhibit a commitment to service excellence, professionalism, compassion, and strong listening skills. Display empathy, optimism, resourcefulness, and cultural competency in all interactions.
Compensation:

Hourly Pay Range MIN: $35.36 (The offered hourly rate is based on relevant experience in a similar role).