Address
Form of workReceives and interviews patients to collect and verify pertinent demographic and financial data prior to patient’s scheduled day of service. Collects required payments or makes necessary financial arrangements. Performs all assigned duties in a courteous and professional manner.
ACCOUNTABILITIES
Incumbents may be required to perform job related tasks other than those specifically presented in this job description. The following is not an extensive list of responsibilities. This list of essential duties and responsibilities are intended to provide a representative summary of the major duties and responsibilities performed. At all times, employees are expected to model the KDH Standards of Behavior.
Verifies insurance eligibility and benefits utilizing electronic or online eligibility tools or by telephone inquiry to the payor.
Documents information obtained through insurance verification in the system.
Assigns appropriate insurance plan from the payor response or representative.
Ensures coordination of benefits are correct.
Pre-Registers patient or other source via telephone (in accordance with HIPPA Guidelines) to secure information relative to financial status, demographic data and employment information.
Enters accurate information into Meditech and/or LSS
Confirm the most recent and current insurance card is on file.
Follows up for incomplete and missing information.
Initiates pre-certification process as required according to Department Guidelines.
Prints appropriate forms and documents which require patient/representative signature such as, but not limited to, Care Agreement, Communication Profile, Liability Assignment, Advanced Beneficiary Notice (ABN), to designate printer for packet preparation and patient signature.
Communicates patient's estimated financial responsibility and requests payment prior to or accepts promise to pay at the time of service and documents in Meditech B/AR notes.
Receives on-line payments and issues receipts.
Maintains daily deposit log and makes daily deposits according to departmental Cash Handling policies and procedures.
Prepares and distributes appropriate reports and documents required. This includes, but is not limited to schedules, productivity logs, monthly collection report etc.
Notifies patients, family members, physicians and/or supervisors of network insurance coverage issues that may result in coverage reduction or non-reimbursement.
Completes Medical Necessity Check and Medicare Secondary Payor Questionnaire (MSPQ) in accordance with Regulatory Guidelines.
Maintain productivity level and quality assurance as established by Patient Financial Service leadership and best practice
Develops strong working relationships with all units within Patient Access such as, but not limited to Hospital Based Registration team, Financial Advisor, Ancillary Departments to ensure maximum communication and coordination of service delivery
Two years of post-high school education or the equivalent business experience preferred
Strong interpersonal and communication skills. Computer experience with PC concentration and the ability to analyze data and generate and interpret reports.
Meditech or LSS experience preferred.
Microsoft Office applications (Access, Excel, Word, Project) and Lotus notes preferred.
Must exhibit a high degree of personal initiative, sound judgment, maintenance of confidentiality and discretion, and excellent decision-making skills to achieve organizational objectives.
Requires a "team player" with excellent interpersonal skills, both verbal and in writing.
Shall be able to articulate the organization's goals and mission.
Must be able to interact with a diverse population.
Ability to recognize when there is a problem situation and escalate to management
