Patient Financial Resolution Advocate

About the role

Interprets and applies WVUHS financial policies to make appropriate financial decisions and payment arrangements to ensure the financial viability of WVUHS. Prepares and presents fee estimates to current and potential patients. Provides financial education regarding benefits to patient to assist in understanding their personal financial liability.

Responsibilities

• Interviews patients who are referred for financial counseling in person or via the telephone to determine financial counseling needs and to help formulate a plan for financial resolution.
• Uses CPT codes to calculate the estimated procedure cost.
• Communicates with the patient the anticipated self-pay portion for upcoming services and explores financial resolution options with the patient.
• Initial determination of patient's eligibility based on hospital policy.
• Refers patients to local, state and/or federal agencies for assistance as needed.
• Educates patient on their benefits, patient liability and/or the process for applying for Medicaid, completion of the financial assistance application, and payment alternatives.
• Works with specialty departments to establish appropriate financial arrangements for elective services.
• Identifies and accurately resolves potential patient account issues for WVUHS billing departments.
• Maintains knowledge of revenue cycle operations, third party reimbursement, local/state/federal regulations and medical terminology.
• Ensures compliance by staff to hospital, governmental, and insurance regulations.
• Monitors accounts to facilitate timely follow-up for financial resolution.
• Provides excellent customer service to patients, visitors and employees.

Requirements

Minimum Qualifications:

• High school graduate or equivalent.
• Two (2) years of experience in a healthcare setting.

Qualifications

Knowledge will include at minimum, all aspect of payer relations, claims adjudication, contractual claims processing and general reimbursement procedures.

• Uses excellent customer service, written and oral communication skills.

Skills

• Uses system software, including online credit card systems.
• Assists in resolving patient billing questions.
• Clear accurate documentation of all patient communications and account activities.
• Uses payer portals and payer websites to verify eligibility.
• Participates in educational programs to meet mandatory requirements and identified needs regarding professional growth.
• Research and process mail returns.
• Develops and maintains working knowledge of all federal, state and local regulations pertaining to hospital billing.

Benefits

N/A

Pay

N/A

Schedule

N/A