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Department: 13448 Enterprise Revenue Cycle - Enterprise Self Pay Estimation and Contact Center. Status: Full time. Benefits Eligible: Yes. Hours Per Week: 40. Schedule Details/Additional Information: Remote position M-F 8:30-5pm.
Job Responsibility:
Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service
Communicates patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments
Requests upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances
Interviews uninsured patients to assess for qualifying financial needs
Initiates credit scoring to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs
Works in conjunction with state social worker and/or outside eligibility vendor to assist in the appropriate completion of Medicaid applications
Demonstrates working knowledge of insurance benefits, insurance companies, and Marketplace insurance options
Educates physician office/patient on the organization’s applicable policies
Stays current on regulations and eligibility requirements for government funding, especially Medicare and Medicaid
Collaborates with peers in the operational flow for uninsured patients or patients that are concerned about costs for upcoming services
Serves consumers in various settings, including virtual, bedside, Emergency Department room, clinic exam room, Urgent Care, consult space, or a Financial Resource Specialist office
Requirements:
High School Graduate, or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)
Typically requires 2 years of experience in Patient Access, health care, insurance industry, or in a customer service setting
Ability to communicate clearly and proactively to management about issues involving customer service and process improvement opportunities
Ability to articulate explanations of HIPAA and EMTALA regulations as they relate to all patient interactions
Has solid knowledge of how various types of insurances operate related to denials and appeals processes
Basic medical coding knowledge
Understanding of insurances, billing and denials
Ability to use a combination of scripted notes and clear, written communication when documenting in patients’ accounts
What we offer:
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs