Financial Case Manager Assistant- Patient Access Management (FT- 1.0 FTE, Day Shift)

Position Summary

Aid in coordinating pre-authorization and assistance programs. Communicate with providers, nursing staff, and patients about insurance guidelines and the pre-authorization process. Assess patient financial needs and provide information on available patient assistance programs. Assist in the claims denial process and develop appropriate appeals responses.

Minimum Qualifications

• High School diploma
• Prior experience in hospital or outpatient clinic setting
• Previous ICD-10 and CPT coding experience
• Previous experience in medical pre-authorization, case management, and/or financial counseling

Essential Job Functions

• Verify eligibility and benefit information with insurance companies and communicate with physicians and staff before services are scheduled.
• Collaborate with staff and referring clinics regarding pre-authorizations.
• Collaborate with staff regarding denials.
• Review patient assistance program guidelines for potential patient enrollment.
• Communicate and collaborate with Clinical Operations Manager.

Knowledge, Skills, And Abilities

• Sound judgment, patience, and professional demeanor
• Strong interpersonal, verbal, and written communication skills
• Creativity, problem analysis, and decision-making abilities
• Ability to work varied shifts
• Tact, discretion, sensitivity, and confidentiality
• Proficiency in computer applications, MS Office, EMR, internet applications, and standard office equipment
• Analysis, organization, prioritization, and meeting deadlines
• Self-directed, accurate, thorough work without oversight
• Strong emotional intelligence, interpersonal, and teamwork skills

Physical Requirements

• Lift 30 pounds of weight
• Carry equipment/supplies
• Sit, walk, or stand for eight or more hours daily
• Work beyond a standard 40-hour workweek, including weekends and after-hours shifts
• On-call availability
• Effective communication
• Handle challenging situations
• Perform repetitive tasks

Exposures

• Bloodborne pathogens, such as blood, bodily fluids, or tissues
• Radiation in settings where medical imaging procedures are performed
• Variety of chemicals and medications used in healthcare settings
• Handling cleaning products, disinfectants, and other substances
• Infectious diseases due to contact with patients in areas that may have contagious illnesses