Patient Financial Specialist, FT, Days

About the role

Performs in-depth demographic and financial assessments (generally at the bedside) and analyzes the results to determine an appropriate payor source. Responsible for the collection of deductibles, co-pays, and co-insurances as well as payment towards accounts classified as self-pay. Assessments often include the need to assist the patient with financial needs and contact outside agencies such as Vocational Rehabilitation, Department of Health and Human Services, Social Security Administration, and others. Partners with Social Work and Outcomes Management to ensure the most appropriate continuum of care for the patient.

Responsibilities

All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference.

• Interviews patient and/or patient's representative (in accordance with HIPPA Guidelines) to obtain complete and accurate demographic and financial information.
• Possesses and demonstrates knowledge of computer systems and financial counseling processes allowing the ability to follow through with all assigned accounts timely and accurately to the satisfaction of the internal and external customer.
• Exercises judgement in analyzing the information collected and following through to ensure the patient receives every consideration for financial assistance.
• Ensures elimination of all possible payor sources prior to consideration of hospital sponsorship.
• Communicates patient's estimated financial responsibility and requests payment prior to or at the time of service; appropriately explaining insurance terms to the patient.
• Receives payments and issues receipts in accordance with departmental cash handling procedures.
• Continually excels at the performance benchmark standards.
• Monitors high dollar accounts that represent significant exposure to ensure complete and accurate financial and demographic information necessary for timely submission and reimbursement of the account.
• Initiates authorization and insurance verification processes as necessary and communicates changes to those departments who need to be made aware.
• Coordinates and delegates referrals to the Department of Health and Human Services for an application to be completed.
• Monitors to ensure applications are secured in a timely manner.
• Demonstrates superior interpersonal relationship skills necessary for developing and maintaining positive professional relationships with patients, peers, clinical departments, payor organizations, and industry organizations.
• Maintains superior revenue cycle knowledge through an ongoing review of governmental, managed care and other third-party payor regulations and guidelines.
• Explores any possible payor source options such as Cobra, Liability, Worker's Compensation or other Governmental Agencies.
• Participates in appropriate departmental training and career developmental opportunities.
• Contacts Social Security