Patient Financial Advisor

Responsibilities

• Educates, screens, and assists patients who do not have valid insurance coverage to enroll in third-party eligibility programs.
• Interviews qualified patients for potential funding sources, which may include Medicaid, financial assistance programs (FAP), and/or alternative funding sources.
• Performs all associated functions timely and accurately.
• Edits patient during interview on applicable policies such as point-of-service collection, payment options, and financial assistance.
• Follows up with patients and the Division of Medicaid to ensure appropriate completion of applications and submission of all required documentation.
• Stays informed on applicable statues, regulations, and Office of Compliance policies that affect assigned tasks.
• Sends Medicaid applications timely and accurately.
• Makes appointments with patients who present as self-pay to obtain valid insurance coverage, if applicable, and/or review prior account information to obtain insurance coverage.
• Consistently interacts with sensitivity to patients/their families and is responsive to individual needs.
• Exhibits excellent customer service and communications skills, with the ability to effectively calm patients and be able to deal with distressed and/or agitated patients and their families.
• Serves as support to patients and their family members to assure customers have access to all available funding.
• Analyzes patient financial condition based on interview and inputs into financial counseling system.
• Documents all calls, correspondence, and related activities to each patient's account in the correct place using appropriate tools and language.
• Updates patient accounting information systems.
• Responsible for calculating patient out-of-pocket amounts due and collecting on those amounts for unscheduled inpatient and observation admits having insurance coverage.
• Utilizes effective critical thinking skills and professional approach when handling these collections situations.
• Maintain complete records of all patients applying for indigent or financial assistance to include the application, proof of income, the acceptance/denial letter, and any other applicable documentation.
• Verifies and assures all accounts are ready for routing for approval for charity or billing with adequate supporting documentation within the established time frames.
• Demonstrates ability to work independently, be attentive to detail, and ensure work is completed timely and accurately.
• Works in self-directed manner and requires minimal supervision.
• Demonstrates ability to manage multiple and simultaneous responsibilities and to prioritize duties/tasks.
• Identifies trends that may indicate problem areas and alerts Supervisor/Manager/Director of such.
• Plays key role in initiating solutions.
• Works closely with Case Management (UR) on a daily basis in regard to notification of active Medicaid coverage, authorizations, and changes to Healthy Louisiana Plans;
• Obtains needed authorization and forwards to Utilization Management when received.
• Maintains daily contact with Utilization Management, Business Office, patient Registration, Medical Records, Ancillary departments, various third-party agencies, HMO/PPOs, patients, patient families, physician offices and other outside entities.
• Actively participates in and encourages other to utilize creative and innovative approaches to accomplish tasks.

Qualifications

• Bachelor's Degree
• 1 year of experience in healthcare financial services, insurance, customer service, or billing/patient accounts.