Address
Form of work
SalaryJob Objective:
Under the supervision of the Department Supervisor, or designee, performs financial counseling duties which include collecting patient payments and issuing receipts, and providing general customer service assistance with patient account inquiries. Ensures that all assigned patients obtain financial clearance for services. Works closely with other departments, such as Patient Care Coordination to ensure patient accounts are secured. Interviews patients to address all missing information and outstanding patient liabilities, Identifies patients who may be eligible for government program assistance and refers, as appropriate for completion of applications. Assists patients with AVH's Payment Assistance Program, provides applications, and, where necessary, assists in the completion of that application. Calculated patient liabilities, makes payment arrangements and collects monies from patients.
Primary Duties and Responsibilities:
- Financial Counseling
- Interviews patients to obtain, clarify and verify all demographic and insurance
information, not previously gathered, and determines status of financial clearance, as needed
- Identifies old, outstanding patient liabilities and calculates patient liability for proposed services in order to determine with patient how to resolve existing and projected liabilities and collects monies, as appropriate
- Provides referral to external agencies and/or third party vendors, which provide financial assistance for medical coverage, through various government programs
- Provides information and assists patients with the completion of the Payment Assistance
application
- Analyzes patients' ability to meet financial obligations and sets up appropriate payment plans
- Identifies patients with special financial circumstances to assist in resolving current and future liabilities
- Acts as an information resource for AVH personnel, who are seeking answers to financial concerns for their patients
- Works closely with and provides assistance to other departments, including Patient Care Coordination, Social Service, and Physicians services, related to information on insurance coverage
Secondary Duties as Assigned:
A. Insurance Verification
- Identifies old, outstanding patient liabilities and calculates patient liability for proposed services in order to determine with patient how to resolve existing and projected liabilities and collects monies, as appropriate
- Ensures accuracy of registration information for correct billing and updates accounts as needed
- Communicates concurrent review requirements to PCC in a timely manner to prevent delays or reduction of claim patment
Non-Essential Duties:
- Assist Operation of the insurance verifiers as need
- Assist with the operations of the Registration Compliance Auditor as needed
- Assist with other duties as assigned, within skill sets and abilities
Knowledge, Skills and Abilities:
Knowledge
- Knowledge of medical terminology
- Knowledge of HMO, PPO, Commercial, and Workers' Compensation reimbursement
- Knowledge of Managed Care contract language
- Knowledge of basic arithmetic
Skills
- Basic personal computer skills to include Microsoft Office applications
- Knowledge of the use of a calculator
- Proficient in the operation of scanners, copiers, and fax machines
Abilities
- Ability to handle stress
- Ability to manage a heavy caseload in an organized and efficient manner
- Ability to recognize potential accounts receivable related problems and offer solutions to management
- Ability to maintain a working relationship with other departments within the organization
- Ability to review all billing transactions for accuracy, discrepancies, and appropriate charges
- Ability to document account information at time of account follow-up
- Ability to run accounts receivable reports as needed
Core Competencies: All AVH employees will effectively demonstrate these behaviors:
Accountability
Action Oriented
Customer Focused
Compassion
Effective Communication
Teamwork
Ethics & Values
Integrity & Trust
Education and Experience:
Education
- High School graduate or equivalent
Experience
- 2 years recent experience in an Admitting Department in an acute care setting. Will consider 2 years recent acute care hospital Business Office experience 2 years previous Commercial, HMO, PPO, and Workers Compensation billing and/or insurance follow-up experience, preferred
AVH Conduct/Compliance Expectations:
Ability to adhere with AVH Leaves of Absence Policy
Ability to adhere with AVH Paid Time Off (PTO) Policy
Ability to adhere with AVH Recording of Hours Worked Policy
Ability to adhere to the department dress code
Ability to organize work and establish priorities
Ability to expand on own initiative in performance of duties
Skill and ability to follow the telephone etiquette/standards
Conforms to AVH Standards of Excellence
Ability to function effectively under pressure and meet time parameters
Ability to communicate effectively while maintaining good working relationships with co-workers,
managers and other hospital staff
Ability to adhere to the normal standards of courtesy and conduct as defined under the rules of
hospitality at AVH
Ability to maintain the confidentiality of patient, hospital and department information
Ability to adhere to safety rules and regulations
Safely and effectively uses all equipment necessary to carry out duties
Ability to interpret and function under hospital and department policies and procedures
Conforms with required and appropriate JCAHO requirements
Conforms with and supports hospital quality assurance and improvement guidelines
Ability to participate effectively in department and hospital staff education
Display a willingness to work as a team player
Ability to give and support the highest level of patient/customer satisfaction at all times
Supports and adheres to the values and mission statement established by the AVH Board of Directors
Ability to demonstrate knowledge and understanding of Corporate Compliance rules and regulations,
complies with duty to report behavior standard, demonstrates understanding of purpose for Corporate
Compliance hotline and importance of seeking guidance from a supervisor when in doubt regarding a
possible corporate compliance issue
Physical Requirements and Working Conditions:
- Primarily works in a climate-controlled area
- Sitting 80% of time on duty
- Tolerate repetitive arm and hand movements
A detailed description of the physical requirements of this job is maintained in the Employee Health Department.
Education and Experience:
Education
- High School graduate or equivalent
Experience
- 2 years recent experience in an Admitting Department in an acute care setting. Will consider 2 years recent acute care hospital Business Office experience
- 2 years previous Commercial, HMO, PPO, and Workers Compensation billing and/or insurance follow-up experience, preferred
