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SalaryResponsible to provide excellent customer service to all members of the Center. Ensures patient accounts are managed and assists patients with account summarization. Facilitates client qualification for and enrollment in a Qualified Health Plan (QHP) through the Federal Marketplace, Medicaid/CHIP and/or other health programs/grants. Assists qualified individuals in making informed decisions on the selection of a health plan if available. Maintains confidentiality of all patient information.
DUTIES AND RESPONSIBILITIES:
1. Performs new patient registration, updates patient information, data entry of demographics, and any other required information. Verifies third party benefit coverage to include co-pays, deductibles and co-insurance. Ensures accurate activations of plans and programs and records special notations in patient account software; assists patient with registration.
2. Conducts eligibility screening on patients for various programs available through the Center; including predetermination and assistance with application completion for special funded programs; accurately places clients on appropriate programs based on funding source requirements; refers potential eligible Medicaid patients to the State Medicaid worker and/or facilitates the enrollment of Medicaid. Performs follow-up eligibility process to include contacting patient for additional information and contacting the funding source for eligibility status.
3. Prepares for next day clinic session to include reviewing and confirming appointments, noting alerts for payments and balances, obtaining current insurance information, updating proof of income, pre-registering patients, and screening patients for program eligibility.
4. Maintains knowledge and expertise in eligibility, enrollment, and program specifications of the Federal Marketplace and other health coverage programs such as Medicaid and CHIP. Complies with departmental policies and funding source requirements; maintains current level knowledge of updates in funding source regulations.
5. Ensures the protection and security of a consumer’s personal, confidential and identifiable information in a professional and responsible manner, according to the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).
6. Processes credit card payments, ensures payments are applied correctly in patient accounts. Completes end-of-day reconciliation report; ensures that credit card payments reconcile with practice management report.
7. Assists with training support staff on insurance verification, entering demographics, program eligibility requirements, payment processing, and other related duties.
8. Provides exceptional internal and external customer service. Communicates with clients, support staff and third party payors to address billing questions and concerns regarding charges payments, adjustments, benefits and possible refunds. Makes payment plan arrangements with patients when appropriate.
9. Performs other related duties as assigned.
JOB QUALIFICATIONS:
High School graduate or equivalent required
Minimum one year experience in front office duties, including insurance verification and referrals
Must complete a minimum of 30 hours of training to obtain Consumer Assistance Certification within six (6) months of employment; and recertify annually.
Proficiency in Word, Excel, Internet/Intranet and EHR (Electronic Health Record) data entry skills
Has knowledge in healthcare billing, to include Medicaid, Medicare, and Private Insurance
Demonstrates good verbal and written communication, with interpersonal and organizational skills
Ability to handle multiple tasks ensuring completion with minimal supervision and attention to detail
Bilingual (English/Spanish) preferred
Scheduled hours and/or work locations are subject to change
PHYSICAL ACTIVITIES AND REQUIREMENTS:
Finger Dexterity: Using fingers to make small movements such as typing or picking up small objects.
Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.
Hearing: Able to hear average or normal conversations and receive ordinary information.
Repetitive Motions: Frequently and regularly using the wrists, hands, and fingers.
Visual: Average, ordinary, visual acuity necessary to prepare or inspect documents or other materials.
Physical: Sedentary work; sitting most of the time. May have to lift folders, files, papers, audio/video equipment, and other such items weighing up to approximately 25 lbs.
Education
Required- High School/GED or better in General Business
