PATIENT FINANCIAL ADVISOR

About the role

The Insurance Verifier/Financial Advisor position ensures appropriate reimbursement resources are in place for services provided, or screens patients for potential Medi-Cal or Charity Care qualification if they are not insured or underinsured. This includes verifying demographic and insurance information, determining payer and patient liability, obtaining authorizations, communicating with patients, and providing options for care.

Responsibilities

• Verifies insurance and determines payer and patient liability
• Obtains tracking numbers for admissions, observation services, and procedures
• Advises patients and family members on insurance benefits, exclusions, and financial obligations
• Determines primary coverage when multiple insurances are involved
• Collects and verifies insurance eligibility as it applies to services rendered
• Collaborates with AHMC Seton Medical Center Business Services collections staff to monitor patient accounts
• Determines patient third party insurance coverage and validates benefits pertinent to services provided
• Gathers and analyzes patient information on medical needs, financial resources, and circumstances
• Interprets and relays provisions and requirements of applicable private, federal, state, and county aid programs
• Ensures appropriate authorizations and/or TARs are obtained prior to elective services being provided
• Provides information for uninsured and underinsured patients regarding self-pay discounts and Financial Assistance (Charity program)
• Sets up payment arrangements as needed
• Performs other duties as assigned

Requirements

The employee must frequently lift up to 25 pounds and push/pull up to 25 pounds. Specific vision abilities required by this job include close vision. The duties of this job include possible exposure to gases and fumes, blood and body fluids, and hazardous chemicals; the employee must understand and demonstrate the ability to take protective actions, following established guidelines.

Qualifications

• High school graduate or equivalent required
• Baccalaureate degree from an accredited college or university with a degree in business, hospital administration, or public health preferred
• Minimum of 1 year of Patient Accounting/Insurance Verification and/or Admitting experience in an acute care setting

Skills

• Expertise in insurance benefit confirmation and follow-up
• Knowledge of hospital credit and collections processes
• Ability to work well with a variety of positions, including physicians, Case Management, nurses, Admitting, and Patient Financial Services staff
• Proficiency with Microsoft Office Suite, current ADT applications, and database management
• Able to learn new software applications and/or programs as needed

Benefits

Not specified

Pay

Not specified

Schedule

Not specified