Patient Finance Specialist

Patient Finance Specialist

Patient Finance Specialist is responsible for timely and accurate patient registration. Interviews patients for all pertinent account information and verifies insurance coverage.

Responsibilities :

• Interviews patients and / or family / relative or other responsible party at workstation or at bedside to obtain all necessary account information.
• Bedside registration performed utilizing carts / computers on wheels.
• Obtain patient demographic information with insurance and financial information, as warranted.
• Searches MPI (Master Patient Index) completely and assigns the correct medical record number.
• Notify supervisor or designate of any medical record numbers.
• Verify all insurance and obtain pre-certification / authorization for services, as warranted.
• Obtain proper authorization for treatment and approved codes from insurance carriers.
• Assigns insurance plan accurately.
• Calculate and collect patient liable amounts.
• Explain policies regarding services rendered according to JHS collection policies.
• Receives and processes all patient payments in accordance with JHS Collections Policy and Procedure-issues receipts and maintains the integrity of all payments.
• Secures all required signatures are obtained for treatments, release of medical information, assignment of insurance benefits and payments of services from legally responsible parties.
• Obtains copies of necessary patient identification and insurance cards. Scans all documents timely.
• Answers any questions and explains policies clearly. Assists patients and / or family / relative with appointment scheduling, as warranted.
• Process patient charts according to paperwork flow needs and established productivity standards.
• Produce paperwork on each patient for distribution to appropriate departments.
• Align pertinent documents for establishing the patient's medical record and financial file.
• Welcomes patients and family members in a professional manner.
• Contacts clinical staff for emergency medical needs and answer patient and visitor questions.
• Informs patient of or their representative of delinquent accounts and attempt to obtain payment.
• Check for physician orders and attached them to the patient medical records to ensure that patient is receiving appropriate tests.
• Guides patient to his / her destination or refers patient to an available Guest Services Representative.
• Responsible for timely bed assignment in to ensure patients are placed in appropriate unit based on established criteria. (Specific for Behavioral Health Center).
• Works closely with unit managers to problem solve issues related to transfers to or from external facilities. (Specific for Behavioral Health Center).
• Reviews insurance contract matrix to verify appropriate hospital placement in accordance with the patient's insurance plans. (Specific for Behavioral Health Center).
• Attends in-services presentations and completes mandatory education, as warranted. Attends minimum of 80% of scheduled staff meetings.
• Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs all other related job duties as assigned.

Experience :

Generally, requires 0 to 3 years of related experience.

Education :

High school diploma is required. Bachelor's degree in related field is strongly preferred.

Skill :

Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications.

Credentials :

Valid license or certification is required as needed, based on the job or specialty.

Unit Specific Credential :

Working Conditions :

Physical Requirements- Job function is sedentary in nature and requires sitting for extended periods of time. Function may require frequent standing or walking. Must be able to lift or carry objects weighing up to 20 pounds. Jobs in this group are required to have close visual acuity to perform activities such as : extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment. Additional information and provision requests for reasonable accommodation will be provided by the home unit / department in collaboration with the Reasonable Accommodations Committee (RAC).

Environmental Conditions- Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Possible exposure to various environments such as : communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May wear Personal Protective Equipment (PPE) such as gloves or a mask when exposed to hospital environment outside of office. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit / department in collaboration with the Reasonable Accommodations Committee (RAC).