Financial Rep Access Dept

Description

Serves as the first contact for patients and families regarding funding sources for inpatient and outpatient services. Responsible for the day to day activities of obtaining funding for patients in the statuses of scheduling, pre-registration, registration, or post registration as assigned.

Screens all admissions on a daily basis and educates referring physicians offices, patients and their families on hospital policy and procedures regarding various methods of payment source for services rendered.

Works in collaboration with all departments and units in the revenue cycle to appropriately communicate issues and/or barriers, and to formulate work plans for resolution.

Obtains appropriate up front collection on all self pay accounts as well as co-pays, deductibles, and co-insurance as identified in information provided by the patient's insurance card or through the eligibility and verification process.

Screens the patient for possible other 3rd party and charity eligibility and keeps up-to-date on admission/business office insurance procedures.

Adept at utilizing payer resources and web sites to accurately explore and assess eligibility and successfully initiate referrals for MediCal/CMS/CCS.

Appropriately administers the Palomar Health Financial Assistance Policy and Procedures to determine if the patient is eligible for discounted prices for services or is eligible for charity care designation.

Well versed in policy and procedure that pertains to AB774 and is able to assist the patient/family in determining if they qualify based on federal poverty guidelines.

Responsible for careful financial evaluation of all admissions, taking appropriate steps that are most beneficial to the hospital, while giving the proper level of consideration to the patient.

Must be firm and decisive, yet courteous, tactful, considerate and show concern and empathy for the patient/family under often stressful situations.

Must be keen, alert and have the ability to effectively communicate with people from various education backgrounds.

Must have the knowledge and confidence to make decisions regarding methods of payment and have the ability to work with frequent interruptions.

Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position.

Job Requirements

• Minimum Education: High School Diploma and/or combination of education and experience
• Preferred Education: High School Diploma and/or combination of education and experience plus 1 year healthcare-related experience or basic college/medical coursework to learn medical terminology
• Minimum Experience: 2 years Patient Access and/or Patient Financial Services experience assisting patients with insurance and government funded programs
• Preferred Experience: 3+ years Patient Access and Patient Financial Services experience assisting patients with insurance and government funded programs, including experience related to billing and payment of government funded health plans.
• Bilingual (Spanish)

Required Certification

Not Applicable

Preferred Certification

• Certified Healthcare Access Associate (NAHAM) or equivalent

Required License

Not Applicable

Preferred License

Not Applicable