Overview
This role is within an organization operating in the academic healthcare system sector, focusing on financial and administrative challenges related to patient access and revenue cycle management. The position supports complex processes such as patient registration, insurance verification, and financial assistance to ensure efficient reimbursement and compliance with healthcare regulations. It involves coordination of revenue flow for various patient account types and collaboration with clinical and administrative teams supporting hospital and physician services.
Responsibilities
- Collect and verify patient demographic, guarantor, and insurance information
- Ensure preauthorizations, referrals, and precertifications meet payer requirements before scheduled encounters
- Collaborate with clinical staff to obtain necessary information for authorization processes
- Assist patients and representatives in securing reimbursement for hospital and physician services
- Support patients in selecting insurance coverage or financial assistance options
- Coordinate patient accounts with coverage vendors, financial services, and case management
- Manage all patient account types including outpatient, inpatient, emergency department, and physician groups
- Understand inpatient/outpatient treatment policies and revenue cycle processes
- Perform patient registration via phone or face-to-face interviews
- Verify insurance benefits and coverage for scheduled services
- Prioritize work to complete tasks before patient arrival
- Document authorization information to ensure clean billing and payment
- Identify patients needing financial assistance and provide applications or referrals
- Counsel patients on financial responsibilities and payment procedures
- Advocate for patients to resolve inquiries and disputes
- Stay updated on relevant healthcare regulations affecting billing and patient rights
- Assist with financial assistance and Medicaid applications
- Explain Health Insurance Exchange plan options and facilitate patient access
- Collect payments prior to service delivery using the designated system
- Resolve charge disputes, process refunds, and make account adjustments
- Escalate issues requiring administrative review
- Meet daily productivity and quality standards and participate in audits
- Perform additional duties as assigned
Requirements
- Minimum two years of experience in medical insurance verification and hospital finance, including billing
- Proficiency with Windows-based PC systems
- Strong initiative and problem-solving skills
- Ability to analyze financial data with attention to detail
- Capacity to multitask and adapt to a changing environment
- Independent problem-solving skills and teamwork orientation
- Knowledge of accounting principles
- Excellent verbal, math, and presentation skills
Preferred Qualifications
Compensation
- Pay range and compensation package will be determined based on the candidate’s experience, skills, and other relevant factors.
Equal Opportunity
The employer is an equal opportunity organization committed to diversity and inclusion. All qualified applicants will receive consideration without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Location
This role involves coordination with hospital and physician services and may require interaction via phone or face-to-face interviews as part of patient registration and counseling processes.