Upfront Financial Advisor

 Coffee Regional Medical Center

Upfront Financial Advisor 

 POSITION SUMMARY

•    To collect payment on services rendered in a timely and efficient manner and to answering all inquiries from the patients in a courteous and timely manner.

 OVERVIEW

•    The evaluation is to assure individual performance, departmental goals and organizational goals are aligned. It is designed to support communication between the manager and the employee. Employee perception of their own performance is very important. To maximize the benefit of this process, both the manager and the employee participate in the evaluation process.

  QUALIFICATIONS

A.    Knowledge, Skills and Abilities

•    Excellent customer service skills.

•    Reads and understands the English language.

•    Ability to think critically and analytically with little or no supervision

•    Ability to work effectively in situations of high stress and conflict and communicate goals and outcomes.

•    Ability to process information and prioritize

•    Possesses exceptional verbal and written communication skills

•    Possesses independent work habits, is self-reliant and self-directed

•    Ability to learn, adapt, and change as required by the job functions

•    Ability to maintain absolute confidentiality of material and information accessed and reviewed

•    Basic computer literacy

•    Ability to move freely, reach, bend, and complete light lifting

•    Ability to use good body mechanics while performing daily job functions and ability to follow specific OSHA guidelines

•    Ability to maintain attendance to meet standard job practices

B.    Education

•    High School Graduate or G.E.D. required.

C.    Licensure

•    C.P.A.R. certification preferred.

D.    Experience

•    Minimum of five years experience is required in medical or financial field.

•    Knowledge of Third-party payers, billing requirements and reimbursement methods required Collections or billing experience required

E.    Interpersonal skills

F.    Essential technical/motor skills

G.    Essential physical requirements

•    Sedentary: Exert up to 10 lb. of force occasionally and/or a minute amount frequently - greater than 75%

H.    Essential mental requirements

I.    Essential sensory requirements

J.    Other

•    Basic understanding of Medicaid, Medicare and Commercial Insurance guidelines.

•    Analytical and organizational skills must be above average.

•    Attention to detail, communication, and documentation skills must be excellent.

•    Prior public relation experience is required.

•    Operations of computer systems and business machinery also required.

•    Must have the ability to communicate with patients in a courteous manner and possess excellent telephone communication skills with the ability to remain calm in difficult situations.

•    Must have the ability to talk with public in a professional manner and be able to interpret patient charges and explain in detail.

•    Must have excellent interpersonal communication skills and possess professional and neat appearance.

•    Flexible work hours: 9:00am-6:00pm

K.    Equipment used

 OTHER QUALIFICATIONS

A.    Exposure to hazards (body fluid exposure level)

•    Level III

B.    Age of Patient Populations Served

•    Infants 30 days - 1 year

•    Children 1 - 12 years

•    Adolescents 13 - 18 years

•    Adults 19 - 70 years

•    Geriatrics - 70 years

 JOB SPECIFIC DUTIES AND PERFORMANCE STANDARDS

•    Below are those tasks, duties, and responsibilities that comprise the means of accomplishing the position’s purpose and objectives. These are critical or fundamental to the performance of the position. They are the major functions for which the person in the position is held accountable. Following are the essential functions of the position, along with the corresponding performance standards.

o    Accuracy

    Maintains 95% accuracy rate or higher.

    Notifies physician offices of determination of hospital based charity application when appropriate.

o    Other

    Complies with time and attendance policies. Attends to personal matters during breaks to avoid conflicts with work.

    Follows proper chain of command for issues, complaints, etc.

    Responds appropriately to department and facility codes.

o    Ability to produce workable ideas and techniques, willingness to attempt new approaches and perform job duties independently.

    Performs duties in an independent manner with minimal direct supervision.

    Can solve day to day problems within scope of practice and make decisions in a timely manner.

    Offers workable ideas, concepts and techniques to improve productivity.

    Willing to attempt new job duties, tasks, etc.

    Maintains regulatory requirements including all state, federal and Joint Commission regulations related to Patient Financial Services and, as appropriate, to the facility.

    Performs any other task as requested by Supervisor or Management in a willing and positive manner.

o    Major Task, Duties, and Responsibilities

    Effectively, yet professionally, request and collects patient estimated balances, including co-payments, co-insurance and deductibles. Advises responsible party and arranges an acceptable payment arrangement as stated in payment policy guidelines.

    Monitor all uninsured patients admitted for observation, surgery, and inpatient setting, explains to patients their estimated financial obligation and assists patients in determining the best method to meet their obligation, including advising patient of free and reduced charge program and application process. Request Deposits on in-house patients based upon sliding scale on the Federal Poverty Levels

    Monitor uninsured patient accounts after discharge through work queues for all uninsured observation, surgery, and inpatients after discharge to insure patients comply with requirements of financial assistance requirements to include contacting patients after discharge; contacting patients to provide assistance in obtaining necessary information.

    Process applications for charity assistance program when needed, notifies patients of balance and makes acceptable payment arrangements as stated in payment policy guidelines. Processes adjustments to all applicable accounts based on applications.

    Assist patients with disability process and Medicaid application process, referring potential Medicaid patients to Medicaid Benefit Specialist for screening process.

    Maintain a current knowledge base of Medicaid programs and any policy or regulation changes that could affect collection of receivables. Updates personal manual with current revisions of policies, reviews Communication Board and monitors electronic mail for current regulations.

    Accurately updating patient demographic and insurance information as necessary. Verifies patient insurance through all available methods.

    Determines primary insurance liability in cases requiring coordination of benefits (spouse, dependent child).

    Explains to patients their estimated financial obligation and assists patients in determining the best method to meet their obligation, including advising patient of free and reduced charge program and application process

    Initiates communication to insurance companies to determine extent of coverage (if any), certification requirements and other co-payment provisions.

    Collects co-pay and deductibles on commercial patients based on the insurance verification as defined in hospital’s policy and procedures, issue receipts

    Reviews prior accounts and makes recommendations for their resolution as defined in hospital’s policy and procedures.

    Collects advance down payment on self-pay patients as defined in hospital’s policy and procedures

    Contacts inquiring commercial patients in the daily in house census to provide information of deductibles, copays, estimated patient liabilities. Identifies patients with outstanding balances and provides education/counseling to patients on payment options.

    Documents all contact with patients, family, employers and third party payers in the appropriate HIS system.

    Answers telephone professionally and courteously. Answers all inquiries in a courteous and timely manner.

    Documents all patient complaints in Quantros and forwards to the Customer Service Representative for review.

    Understands the significance of the organization’s Performance Improvement

    Programs and is an active participant.

    Complies with all departmental policies of Patient Access. Including but not limited to the degree of accuracy of registrations.

    Reports any problems to immediate supervisor daily as needed.

    Responsible for any and all other functions as required and directed by Supervisor.

    Maintain open communication with Clinical staff to monitor family visits to assist with obtaining information for financial assistance.

    Attend Patient Care Conferences to assist with discharging plans.

    Review Medicare patients without secondary coverage to see if patient eligible for Medicaid or other programs.