• Assembles all data and documents required for complete patient registration, including, but not limited to pre-registration and registration functions; verification of all insurance and authorizations
• Enters all patient demographic information into EMR system; uses other departmental applications for eligibility and authorization.
• Provides financial information and patient payment options. Informs patient/guarantor of liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. Documents payments/actions in the patient accounting system and provides the patient with a patient estimate of out of pocket costs and a payment receipt in the collection of funds.
• Screens and informs patients and clinical staff of Client policies and procedures regarding method of payment sources for services rendered
• Obtains and documents information from patients and provides information on available funding resources; obtains funding for patients within the statues of scheduling and registration
• Uses payer resources and websites to explore and assess eligibility and may initiate referrals to determine patient eligibility for discounted prices or charitable care
• Take payment information and other pertinent information such as addresses and phone numbers
• Review patient account and document customer’s interaction and feedback
• Negotiate appropriate and reasonable payments with customers
• Set up customer payments via check, electronic transfer or credit card
• Works in collaboration with all areas of the revenue cycle to identify and resolve issues and/or other challenges
• Responds to request for information and inquiries about patient access processes, policies and/or other related information; researches and resolves customer concerns
• Serves as just-in-time staffing, working inventory for team members that may be absent or backlogged.
• Identify root cause issues for patient registration or pre-authorization related denials; categorize denial reasons and coordinate with client and/or with management to ensure process improvements are completed
• Owns client's performance and ensure consistent and timely communication for issues identified.
• Accurately and thoroughly document the pertinent collection activity performed.
• Review the account information and necessary system applications to determine the next appropriate work activity.
• Initiate telephone or letter contact to patients to obtain additional information as needed.
• Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
• Provide technical assistance, coaching and training to other team members.Provides periodic quality assurance checks.
• Stay informed of changes with the procedures and laws for the specific insurance carriers or payers. • Assist in special projects assigned by management.
• Participate and attend meetings, training seminars and in-services to develop job knowledge.
• Respond timely to emails and telephone messages from the staff, management, and the client.
• May assist with accounts receivables, claim edit, charge entry, cash research and payment posting, as needed.
• Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions.
• Incumbents are required to have physical attendance onsite at a Strivant Health approved office location to perform the duties of the role by regularly interacting with managers, other staff members, & clients.
Performs other related duties as required or requested.
• High school diploma or equivalent
• A minimum of 3 years’ experience in physician collections with complex denials and appeals management or 3 years performing financial counseling and clearance related to medical financial services.
• Prior experience translating patient access trends into process improvements results
• Previous experience with medical billing systems required, prefer eClinicalWorks (eCW)
• Knowledge of CPT, ICD-9/10 and HCPCS codes
• Sharp intelligence of government payers and other commercial/managed care carrier rules and processes in a professional billing or medical financial services environment
• Attention to detail with the ability to identify/resolve problems and document the outcome
• Strong written and verbal communication skills
• Excellent analytical and problem-solving skills
• Ability to multi-task and recognize trends
• Solid skill with Microsoft Office applications: Word, Excel
• Initiative to learn new tasks and the ability to apply acquired knowledge to future duties
• Flexibility, adaptability, and accountability are necessary for optimum client results
• Hearing: Adequate to perform job duties in person and over the telephone.
• Speaking: Must be able to communicate clearly to patients and clients in person and over the telephone.
• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
• May include prolong periods of sitting, typing, viewing computer/laptop screens, along with occasional bending, reaching, lifting, climbing, twisting, stooping and standing.
• Incumbents are required to have physical attendance onsite at a Strivant Health approved office location.
The above is intended to describe the general content and requirements for the performance for this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.