at Mercy Health Corporation (Mercyhealth) in Harvard, Illinois, United States
Job Description
Overview
Financial Resource Specialist, Patient Access, Days, 80 Hrs / 2 wks
Location: Mercyhealth Harvard Hospital; Harvard, IL
The Financial Resource Specialist position requires extensive knowledge of Mercyhealth financial guidelines, collection policies, and government regulations related to billing and collections. The Financial Resource Specialist will be the embodiment of the hospital's mission, vision and values and will liaison with the various clinic and hospital locations to ensure financial policies are being adhered to. The Financial Resource Specialist will greet patients or family members in the various clinic and hospital settings and assist them in answering any questions or concerns they may have regarding their insurance coverage, financial assistance, billing, or payment options. The Financial Resource Specialist will have knowledge of all aspects of the revenue department from the registration process through the collection, billing, coding and denial process/ Financial Resource Specialists have an extensive knowledge base of all community, state or federal government programs to provide assistance to patients who have no or limited ability to pay for their health care. They are expected to have a comprehensive knowledge base of alternative financial resources to counsel and educate patients on all available financial resource options. They will assist patients and family members with the Presumptive Eligibility process and follow up with patient to ensure they have secured a financial resource in place to pay for their health care. The Financial Resource Specialist also prepares complex estimates for services and counsels patients on their expected personal financial responsibility. . They will keep up to date with insurance plans and payers so that they can appropriately counsel patients on their health care financial responsibilities. The Financial Resource Specialist will also work with patients and their insurance companies to resolve complicated billing and denial issues.
Responsibilities
Follow and administer all Mercyhealth financial policies and guidelines. In depth knowledge of collection laws, an understanding of statement cycles, and the bad debt process.
Maintain a thorough knowledge base of the registration and cash drawer process. Follow all necessary frontline workflows in regards to payment posting, cash drawer balancing and adhere to all cash compliance policies.
Researches and performs audits on patient accounts to determine where balances are due, from third party payers or patient responsibility.
Meet with patients in person or via telephone to counsel patients/customers on billing concerns, account balances, services costs/estimates and various insurance resources.
Establish payment plans with patients and follow up on broken payment arrangements when appropriate. Research patient accounts, process refunds and pay in full discounts.
Communicate with physicians, patient care staff and hospital/clinic reception regarding out of network insurance status, medical urgency and other patient billing/ insurance issues.
Thorough understanding of how to identify if charges are correct. In depth understanding of what information is available to assist in the process, such as the medical record, chartview, MPI, billing, and coding reviews as appropriate
Navigate the billing system and review patient accounts for accuracy. Initiates appropriate follow-up with patient, billing department, coding department, and insurance companies to ensure payment for services.
Familiar with managed care contract reimbursement rates. Understands terminology associated with contracts as well as familiar with terminology and calculations used on a payment voucher and patient's explanation of benefits. Understands Governmental and Commercial insurance reimbursement rates.
Maintain an extensive knowledge base of programs offered through the government, the insurance marketplace, Care Credit, foundation grants, and other financial resource options. Assist patients in obtaining copay and drug replacement assistance for services provided. Screens patients in need and provides assistance with completion of the charity care application process.
Screens self-pay patients for presumptive eligibility for Medicaid and performs necessary follow-up to ensure coverage is in place.
Initiates appropriate follow-up with patients, insurance companies or billing department to ensure payment for services.
Completes insurance eligibility, benefit verification and precertifications as required.
Monitor patient work queues and resolve outstanding balance issues. Contacts patients with self-pay balances to collect payment, set payment arrangements, or provide assistance with financial resources.
Responds to patient inquiries via in... For full info follow application link.
EOE&AA/M/F/Vet/Disabled. Mercy is an equal employment opportunity employer functioning under Affirmative Action Plans.
