Overview
This role is within the academic healthcare sector, focusing on hospital revenue cycle management and patient financial services. The position supports patient access, insurance verification, and reimbursement processes for hospital and physician services, working with a broad patient base and multiple internal and external partners to ensure efficient financial management and patient support.
Responsibilities
- Collect and verify patient demographic, guarantor, and insurance information
- Ensure preauthorizations, referrals, and precertifications meet payor requirements prior to patient encounters
- Collaborate with clinical staff to obtain necessary clinical information for authorizations
- Assist patients and their representatives with reimbursement processes for hospital and physician services
- Help patients identify insurance coverage options and financial assistance programs
- Coordinate with coverage vendors, clinical staff, and patient financial services teams
- Manage patient accounts across outpatient, inpatient, emergency, and physician group services
- Understand inpatient and outpatient treatment policies related to revenue cycle processes
- Conduct patient interviews to gather financial data required for registration and payment
- Verify patient benefits and coverage for scheduled services
- Obtain and document referrals and authorizations to facilitate billing
- Identify patients eligible for financial assistance and provide charity applications or referrals
- Advise patients and guarantors on payment responsibilities and procedures
- Advocate for patients to resolve financial inquiries and disputes
- Stay updated on healthcare regulations and billing guidelines
- Assist with financial assistance and Medicaid application processes
- Collect payments prior to service when required
- Investigate and resolve charge disputes, refunds, and account adjustments
- Escalate issues requiring administrative review according to treatment policies
- Meet daily productivity and quality goals and participate in audit processes
- Perform other duties as assigned
Requirements
- Minimum of two years' experience in medical insurance verification and hospital finance, including billing
- Proficient with Windows-based PC systems
- Strong initiative and problem-solving skills
- Detail-oriented with analytical and financial assessment abilities
- Ability to multitask and adapt in a dynamic environment
- Independent problem-solving capability and team management focus
- Knowledge of accounting principles
- Strong verbal, math, and presentation skills
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.