Patient Financial Advisor
2 weeks ago
JOB SUMMARY:
Under the supervision of the Patient Financial Services Director, the Patient Financial Advisor plays a crucial role in ensuring patients have a seamless financial experience by assisting them in understanding their insurance benefits and potential financial responsibilities.
The Patient Financial Advisor serves as the primary contact for patients seeking financial assistance.This role involves collecting payments, establishing payment plans as necessary, generating cost estimates, and advising patients both in person and via phone regarding their insurance benefits and coverage. In certain instances, the advisor may evaluate patient referrals for suitability.
The Patient Financial Advisor aids patients in determining eligibility for government programs, Cibola General Hospital's financial assistance initiatives, and other avenues for managing significant medical expenses.
PRIMARY FUNCTIONS:
1. Acts as the main point of contact for all inquiries related to financial assistance.
2. Engages with patients to gather and comprehend their financial, social, and medical histories, along with other pertinent information.
3. Collects all necessary information to process financial assistance applications, which includes collaborating with providers on treatment plans and best practices.4. Records all communications and follow-ups in the electronic medical record (EMR) system and sends written confirmations to patients regarding payment arrangements as applicable.
5.
Evaluates the financial circumstances of patients by verifying their insurance benefits, serving as the technical authority in confirming coverage and hospital reimbursement.
9. Completes the referral process for patients identified as having financial risks.
10.
Determines eligibility for care at CGH by evaluating patient qualifications for Medical Assistance, Emergency Medical Assistance, Community Programs, and Government Programs.
12. Identifies available financial programming options and assists in completing all required documentation for specific federal, state, or CGH financial assistance programs.
13. In collaboration with providers, assesses the urgency of scheduled care for patients facing significant financial burdens, leading to decisions regarding proceeding, postponing, or rescheduling care. 14. Communicates CGH's payment policies to patients when no assistance programs are available. 15. Calculates and explains any patient liabilities prior to or at the time of service.16. Advises patients on out-of-pocket expenses and collects deductibles, prepayments, and outstanding balances following established collection protocols; alternatively, formulates a payment plan with the patient and documents the agreement appropriately.
17. If acceptable payment arrangements cannot be established for elective procedures, notifies the provider and patient that services will be rescheduled or canceled.
18.Communicates financial coverage status and relevant financial decisions with all appropriate parties:
patients, families, referring clinicians, and CGH clinicians.
19. Assists in maintaining self-pay accounts, initiates collection procedures when necessary, and sends correspondence to patients regarding account statuses; places accounts in the appropriate financial class before they are sent to collections if patients do not respond to outreach efforts.
20. Engages in educational opportunities to stay informed about changes in the healthcare industry.
21. Fosters effective working relationships and collaborates effectively as part of a team to help the department achieve its goals and objectives.22. Demonstrates respect and consideration for the dignity of all patients, families, visitors, and colleagues to ensure a professional, responsible, and courteous environment.
23. Participates in community engagement activities and clinic events as required. 24. Performs additional duties as assigned. EDUCATION / EXPERIENCE REQUIRED: 1. High School Diploma / GED Required 2. Associate degree preferred. 3. Two years of experience in healthcare Revenue Cycle preferred. 4. Experience in delivering high-quality customer service. 5. Excellent organizational and time management skills, along with strong oral and written communication abilities. 6. Strong team player. 7. Ability to learn quickly, build and maintain long-term relationships, and work with minimal supervision. 8. Proficient computing skills.9. High level of accuracy and attention to detail, flexibility, and the ability to manage competing priorities effectively and in a timely manner, prioritizing tasks efficiently in a team environment.
KNOWLEDGE, SKILLS AND ABILITIES: Knowledge of medical billing and collection practices, proficiency in computer programs, understanding of business office procedures, and basic medical coding and third-party operating procedures. Ability to operate a computer, basic office equipment, and a multi-line telephone system. Skill in answering calls in a pleasant and helpful manner. Ability to read, comprehend, and follow both oral and written instructions. Ability to establish and maintain effective working relationships with patients, colleagues, and the public. Must be well-organized and detail-oriented. ADDITIONAL QUALIFICATIONS: Bilingual (Spanish / English) preferred. RELATIONSHIP REPORTING: Reports to the PFS Supervisor. PHYSICAL REQUIREMENTS: Ability to sit, stand, walk, or view a computer screen for extended periods. Ability to perform repetitive hand and wrist motions for extended periods.-
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