The posting
Primary Purpose
Interviews patients at the time of entry to advise the patient of the optimal funding program, begin eligibility determination, and assure that all Parkland patients are screened and qualified for assistance.
Education
•High school diploma/GED
Experience
•Must have two years experience in determining financial eligibility for government funding, program funding, public funding or patient assistance programs in a physician or hospital business office setting.
Equivalent Education and/or Experience
•May have an equivalent combination of education and/or experience in lieu of specific education and/or experience as stated above.
Certification/Registration/Licensure
•None.
Skills or Special Abilities
•Must be able to interview patients for the purpose of financial eligibility determination.
•Must be able to demonstrate a working knowledge of personal computers and other standard office equipment.
•Must have basic knowledge of medical software.
•Must have basic knowledge of public assistance programs and required forms.
•Must have knowledge of third party payors and insurance verification procedures, and understand managed care and insurance contractual arrangements.
•Must be detail oriented, possess basic mathematical skills, and have sharp analytical skills to resolve financial issues as they relate to multiple groups including third party payors, physicians, patients and the system.
•Must demonstrate a positive demeanor, good verbal and written communication skills, and be professional in both appearance and approach.
•Must be able to handle potentially stressful situations and multiple tasks simultaneously including instructing and counseling patients regarding Parkland payment policies and public assistance programs.
•Must be able to communicate effectively with patients, families, government entities, insurance companies, and Parkland staff.
•Must be able to solve problems within the guidelines of established policies and procedures.
•Basic medical terminology knowledge preferred.
•Must be able to successfully complete additional job related training when offered.
•Bilingual skills preferred.
Responsibilities
- Screens patient demographic and financial documentation to identify appropriate funding program(s) to ensure that all patients who are qualified for assistance are properly instructed and receive benefits. Verify and obtain insurance benefits and forward referrals and pre-certifications to clinical staff to ensure that patient information is complete and accurate and ensure Parkland’s financial viability s secure at the most basic level.
- Assists patients in completing the certification process with all appropriate public funding source agencies to ensure applications are complete, deadlines are met, and the certification process is expedited prior to the patient’s discharge. Sets up and encourages applicants to keep appointments to ensure patient complete the process to qualify for financial assistance.
- Communicates to the patient their financial responsibility and collects co-pays and/or unpaid balances. Provides patients with billing information as required. Enters payments into the computer system to document financial transactions/payment posting. Balances cash drawer at the end of each day. Documents actions taken in the hospital accounting system.
- Assign appropriate coverage to accounts, including outside agencies when appropriate to ensure patient financial responsibilities are fulfilled. Documents actions in hospital accounting system.
- Performs registration functions to include verifying patient identification, patient demographics, and all third party funding payors in order to ensure Parkland’s financial viability is secured at the most basic level. Distributes, offers explanations, and obtains signatures and dates on all required forms as needed. Attaches all appropriate coverages, prioritizes correct filing order, and documents actions taken in the hospital accounting system.
- Tracks productivity and provides cumulative reports on a daily, weekly, or monthly basis.
- Monitors and administers all assigned accounts until the patient’s application, certification, and/or denial process or review is complete and all appropriate coverages are attached and prioritized correctly for proper billing.
- Maintains a positive working relationship with contacts at all agencies and funding programs, patients, insurance companies, government entities, clinical personnel, other Financial Counselors and management, to promote teamwork, cooperation, and a positive public image for Parkland. Serves as a positive role model for staff and patients, demonstrates strong interpersonal and persuasive abilities to ensure client compliance and cooperation with state/ federal agencies. Accepts constructive criticism and integrates suggestions in effective ways.
Job Accountabilities
- Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
- Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
- Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.
