Patient Financial Advisor

Responsibilities

• PFA shall ensure that appropriate reimbursement resources are in place for services provided.
• If patients are registered without insurance coverages, PFA will actively screen all inpatients and outpatients for other insurance coverages.
• Other responsibilities are: verification of demographic and insurance information provided, as well as third party insurances;
• Accurate and timely determination of payer and patient liability, and notifications and initial authorizations required;
• Validate that required authorizations/notifications are obtained for hospital stay and outpatient services,
• Adherence to government and non-government program requirements;
• Effectively communicating with patients as to benefits, program requirements, personal payment liabilities, and options for care and placement that allow for informed decisions by the patient and his/her family while protecting the financial interest of Chinese Hospital Association;
• Provides information regarding self-pay discounts when no other options are available, sets up payment arrangements as needed;
• Discusses patient financial liability for services rendered and collects as applicable for those services;
• Aid eligible patients in the application of Hospital Presumptive Eligibility (HPE), Full Scope Medi-Cal, and referrals to other insurance coverages if not qualifying for Medi-Cal;
• Apply Treat Authorization Requirement (TAR) for all eligible accounts;
• Review all assigned DNFB for appropriate billing actions.

Essential Duties And Responsibilities

• Communicate with patients and insurance companies on the phone
• Appropriately document and report payment information
• Advise patients and/or family members and Case Management (as applicable) of insurance benefits, exclusions and financial obligations.
• Determine primary coverage when multiple insurances are involved, collect and verify insurance eligibility as it applies to services rendered, collect payments, deposits and/or arrange for payment plans if necessary.
• Educate patients about payment options and financial assistance.
• Negotiate and strategize patient payment arrangements.
• Update patient accounts and balances.
• Review and process patient and insurance company forms.
• Work with pharmacies and pharmacy insurance programs to make sure prescribed medications are covered by the patient’s financial resources.
• Provide proper documentation to patient’s insurance company to ensure coverage.
• Communicate with CHA’s 3rd party billing to ensure claims are handled efficiently.
• Ensure all Infusion accounts are pre-admitted, registered and financially cleared.
• Work with front registration during normal business hours to effectively capture uninsured/underinsured patients for financial assistance.
• If during off hours, PFA will reach out to the patients the next business day.
• Follows Hospital and Department policies and procedures at all times, including but not limited to: Administrative Manual, Environment of Care, Human Resources, Infection Control, Corporate Compliance, Code of Ethics, etc.
• Attend, actively participate and complete in-services, training classes, mandatory classes, seminars/workshops, staff meetings, exercises and drills;
• Reads all department communication and assigned materials.
• Customer Service – Provides excellent customer service and shows compassion to all patients, visitors and co-workers.
• Seeks feedback to ensure all needs are met.
• Anticipates and recognizes the concerns of others, even if those concerns are not openly expressed.
• Communication – Keeps manager and team informed of progress, problems, development and plans. Gets along and interacts positively with co-workers and others.
• Accepts and performs other duties as assigned.

Qualifications

• Medical Office Experience
• Computer proficiency (EMR knowledge a plus)
• Effective communication skills to work with patients, families, doctors and insurance providers
• Strong Customer Service
• Ability to effectively present information, both verbal and written
• Ability to take initiative, adapt to changing priorities, and work independently
• Strong time management and prioritization skills
• Knowledge of Medical Terminology including medications

Preferred

• High School Diploma or GED
• Bilingual in Chinese (Cantonese and/or Mandarin) or Spanish
• Knowledge of community resources and cultural needs

Physical Requirements

• Sit, stand, walk, talk and/or listen
• Use hands to do computer work, write reports, do equipment set-up/cleaning/storage, clerical support, etc.
• Frequent use of the phone
• Good vision needed to read schedules, enter accurate data, etc.
• Able to lift up to 30 pounds
• Standing, walking and moving 50% of the day

Compliance Requirements

• Complies with Chinese Hospital Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs.
• Reports suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.

Base Pay Scale

Starting at $30.98-$38.12 per hour. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.