Employment Type:

Full time

Shift:

Description:

POSITION PURPOSE

•  Responsible for ensuring all scheduled services are financially cleared and secured prior to the date of service for Trinity Health. Responsible for obtaining and verifying accurate insurance information, benefit validation, authorization, and preservice collections on all qualifying accounts. This is a key position that begins the overall patient experience and initiates the billing process for any services provided by the hospital.
• As a mission-driven innovative health organization, we will become the national leader in improving the health of our communities and each person we serve. By demonstrating reverence, commitment to those who are poor, justice, stewardship, and integrity, our organization will continue to provide better health, better care, at lower costs.
• ESSENTIAL FUNCTIONS
• Responsible for financially clearing patients for each visit type, admit type and area of service via current HIS (Health Information System). Collects and documents all required demographic and financial information. Appropriately activates registration and canceled or no-show accounts in a timely fashion. 
• Analyzes patient insurance(s), identifies the correct insurance plan, selects appropriately from HIS insurance and plan selections and documents correct insurance order.  Applies recurring visit processing according to protocol.
• Verifies patient information with third party payers. Collects insurance referrals and documents within HIS. Communicates with patients and physician/offices regarding authorization/referral requirements. Identifies potential need for financial responsibility forms or completed electronic forms with patients as necessary. Escalates accounts appropriately in accordance with department Defer/Delay policy to manager.
• Screens outpatient visits for medical necessity and issues Advanced Beneficiary Notice as appropriate for Medicare primary outpatients. Provides cost estimates.  Collects and documents Medicare Secondary Payer Questionnaire (MSPQ) and obtains information from the patient if third party payers need to be billed (i.e., worker's compensation, motor vehicle accidents and any other applicable payer).  
• Maintains operational knowledge of regulatory requirements and guidelines as outlined in the hospital and department Compliance Plans.  Ensures Meaningful Use requirements are met as appropriate.    
• Screens all patients self-pay & out of network patients using approved technology.  Provides information for follow up and referral to the RHM Medicaid Vendor and/or Financial Counselor   as appropriate. Initiates payment plans and obtains payment.  Informs and explains all applicable government and private funding programs and other cash payment plans or discounts to the patient and/or family.  Incorporates point of service (POS) collection processes into daily functions.
• May issue receipts and complete cash balance sheets in specified areas where appropriate.  Utilizes audits and controls to manage cash accurately and safely.
• Communicates and promptly escalates account clearance concerns to management.
• Maintains and exceeds the department specific individual productivity standards, collection targets, quality audit scores for accuracy productivity, collection, and standards for registrations/insurance verification
• Must possess the ability to comply with Trinity Health policies and procedures.  Must be comfortable operating in a collaborative, shared leadership environment.
• Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.
• Other duties as assigned by manager.

MINIMUM QUALIFICATIONS

• High School diploma or equivalent combination of education and experience.
• Must possess a comprehensive knowledge of financial clearance and insurance verification processes with two (2) years of financial clearance experience in an acute care setting.
• Strong knowledge of third-party and government payer billing and reimbursement guidelines as well as department performance standards and policies and procedures.
• National certification in HFMA CRCR and/or NAHAM CHAA within one (1) year of hire.
• Ability to communicate and work with patients, physicians, physician office personnel, associates, multiple direct patient care providers and others in order to expedite the registration/intake process. 
• Superior customer service skills and etiquette is strongly preferred.  Must be proficient in the use of Patient Registration/Patient Accounting systems and related software systems.  Must be proficient i