SUMMARY:

The Financial Representative is responsible for assisting with all functions associated with billing and third-party payers to include the following: authorizations, insurance verifications, maintaining knowledge of insurance contracts and out of network contracts, and working closely with physicians’ offices.

REQUIREMENTS:

• High School Diploma or equivalent.
• 1 – 2 years in a related field. Health care experience preferred. Experience with medical office billing procedures and customer service preferred.
• Knowledge of computers with experience in Windows-based systems and Microsoft Office. Functional knowledge of medical terminology and collection practices. Must be detail oriented.

ESSENTIAL FUNCTIONS:

• Identifies delinquent accounts, aging period and payment sources, and performs collection actions including contacting patients by telephone and resubmitting claims to the appropriate payer.
• Evaluates patient financial status and establishes contract payment plans.
• Keeps informed on all current Medicare, Medicaid, and third-party payer regulations and requirements. Informs management and other staff members of changes and keeps documentation current and accessible.
• Successfully reduces days in A/R and meets assigned goals.
• Responds to overflow of Customer Service incoming patient phone calls.
• Pre-admits, admits, discharges and transfers patients in all areas of the hospital, explains policies, responds to questions related to patient registration, and gathers all necessary information and patient signatures on required forms according to hospital policy and procedures.
• Ensures 98% accuracy in documenting patient demographic and financial information in the hospital’s registration / ADT system.
• Performs pre-admission functions as defined in hospital policy.
• Greets patients, families, and visitors arriving in all areas in a friendly, courteous manner.
• Serves as liaison with clinical departments, patients and families regarding admission and registration processes.
• Actively solicits information from patients, doctor’s office staff, and insurance companies to complete the Admission Questionnaire form and insurance pre-certification information and authorization for the visit.
• Performs scheduling functions as directed by management.
• Identifies collection trends and solves them in a timely manner.
• Other assigned duties as required.