FINANCIAL ADVOCATE SPECIALIST - PFS (FT)

Req # 4815

Coordinate all facets of self-pay credit and collections for Cody Regional Health. Responsible for performing a variety of complex pre-services, financial counseling and customer service-related functions for patients and/or their representative including pre-service estimates, collection of pre-payments, collection of prior debt, addressing billing questions, establishing payment plans, screening for financial assistance, responding to MyChart inquiries and other Customer Service requests.

Will accept any combination of: formal education; and or prior work experience sufficient to demonstrate possession of the knowledge, skill and ability needed to perform the essential tasks of the job. High School diploma or GED preferred.

Experience in hospital setting, physician office and financial area preferred. Physician office, registrations, pre-registration experience preferred. Must have excellent communication skills. Cash collections experience preferred. Insurance related experience preferred.

• Must possess a high degree of confidentiality of all matters with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
  
• Must have strong interpersonal skills with the ability to communicate with staff and public in a friendly, courteous and helpful manner.
  
• Must have excellent organizational skills with the ability to multi-task.
  
• Must have well-developed verbal and written communication skills.
  
• Experience with insurance company prior authorizations preferred.
  
• Ability to adapt to fluctuations in workload, and work efficiently and effectively under stressful conditions.
  
• Willingness to assume additional duties when requested and seek guidance and direction, when needed, for performance of duties and ability to recognize, establish and respond to priorities.
  
• Strong computer and keyboarding skills.
  
• Must be proficient in the use of Microsoft Office Suite products knowledge including Word, Excel and Outlook.
  
• Ability to learn new computer software applications.
  
• Competence in CRH EMR.
  
• Must know basic medical terminology.
  
• Detail oriented.
  
• Exceptional phone etiquette.
  
• Must be self-motivated.
  
• Accountability for the consequences of own actions.
  

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to update the job description adding or changing duties at any time based on the department needs.

HFMA Certifications as appropriate.

• Function as a single point of contact, and work with other departments and teammates to resolve patient questions.
  
• Provide a high level of service for our patients.
  
• Maintain a working knowledge of physician, third-party payer practices, and institutional billing practices.
  
• Handle all patient inquiries to address any/all billing questions via inbound calls, MyChart, patient correspondence and patient walk-ins.
  
• Answer inquiries for incoming calls, mail, and walk-in patients regarding account issues for both self-pay and insurance accounts.
  
• Provides aid to customer service for patient follow up such as assisting patients in the resolution of billing issues, which may include setting up payment plans, responding to complaints, problems, and general inquiries in a timely, responsive, and efficient manner.
  
• Ensures daily closeout and balancing of cash drawer and cash deposits. Prints and files appropriate documentation for backup of daily close out and deposit.
  
• Assists with bank deposits for cash collections from front office and back-office staff.
  
• Deceased:
  

+ Works directly with CRH attorney to check for patient probate/estate.

+ Assists with documentation requirements for filing of creditor’s claims when applicable based on total balance owed and state federal regulations.

+ Monitors expired patient balances and adjusts according to hospital policy.

• Bankruptcy:
  

+ Manages notifications for bankruptcy and appropriately stops billing process for customer under state federal regulations.

+ Reviews overall balances owed for claim filing works with CRH attorney and provides any necessary documentation for claim filing for bankruptcy reimbursement when applicable.

+ Notifies bad debt vendors of bankruptcy status when notifications are received.

+ Follows up with bankruptcy completion or discharge and applies adj or reinstates billing based on court documentation.

+ Process all correspondence from attorneys and courts regarding bankruptcies or collection agency issues.

• Title 25:
  

+ Monitor Title 25 accounts and coordinate any balances that need insurance billing for submission and authorization requirements.

+ Appropriately bills patient for completion of affidavit, payment for account resolution or follow up for non-responsive patients.

+ Monitors unpaid self-pay amount and process necessary paperwork for submission to Park County for contracted reimbursement.

+ Submits and process necessary paperwork for submission state reimbursement when county contract is exhausted or adjusts appropriately.

• State Bed:
  

+ Works with Cedar Mountain Center department for appropriate adjustments for state bed and patient billing per CRH policy.

• Estimates:
  

+ Generate patient estimates for hospital services in compliance with state and federal regulation and hospital policies. Assists with physician estimates on an as needed basis.

+ Contact self-pay patients pre-service to provide patient liability education, explain the estimated cost, and attempt to secure payment and/or set expectation of payment at time of service. Provide payoff (payment plan) options/agreement if good faith payment is made.

+ Provide estimates to patient shoppers upon request.

• Financial Assistance:
  

+ Provide explanation of charity care policy and guidelines and billing question support to all patients receiving services at CRH.

+ Screen and assist patients with financial assistance, Medicaid eligibility and/or other funding sources available.

+ Review eligibility and benefits, and obtain authorization requirements, if needed.

+ Discuss all payment options and discounts with patients before and after discharge.

+ Interview and evaluate patients applying for financial assistance and respond within 30 days of application being completed.

+ Advise patients how to apply for Medicaid and assist in application process if needed.

+ Monitor and track routine follow up on outstanding financial aid applications and approvals. Handles HB/PB patient inquiries to address any financial assistance questions via inbound calls, MyChart, patient correspondence and patient walk-ins.

+ Work with Risk Management for HB and PB patients who have escalated complaints or concerns regarding estimate issues. Work with external customers such as collection agencies and Hospital based clinics to address any patient concerns regarding estimate or financial concerns.

• Ensures adherence to all financial policies.
  

• Will perform Customer Service functions when necessary.
  
• May be required to perform other duties for which the individual is qualified.
  
• Maintain strict confidence of patient information.