Position Objective:

Protects the hospital from losses by ensuring 100% insurance verification and authorization is obtained for inpatient admissions for Medical Park Admissions. Works with patients, and their family to understand the extent of financial responsibility. To assist and guide customers through available programs and funding for assistance with payment for medical services. Manage processes for customers applying for Medicaid program. To serve as a resource and Financial Services liaison to utilization review and clinical services.

Essential Job Duties:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Identifies patients without adequate health insurance.
2. Provides financial responsibility information to patients, family members or physician practice. Communicate hospital payment policy and when necessary recommends funding program to benefit the patient and hospital. Insurance Verification.
3. Takes initiative to ensure 100% of inpatient cases are insurance and authorization obtained.
4. Documents in the electronic medical record system in accordance with PFS policies and procedures; communicates updates any pertinent information in a timely manner.
5. Resets insurance and other data fields with corrections and communicates using reminder system to team leaders for billing.

Educational/Experience Requirements:

• High School diploma or equivalent required.
• Numerical skills and previous Billing/Accounts receivable systems experience required. Excellent verbal and written communication skills.
• One year experience in hospital billing or collections in automated setting.
• For certain positions experience in Medicare, Blue Cross and Medicaid billing is preferred.

Required License/Certifications:

• Certified Revenue Cycle Professional (CRCP) or Certified Revenue Cycle Specialist (CRCS) preferred.

Working Conditions, Equipment, Physical Demands:

There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Physical Demands – Light

The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act.

The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.