Renal Dialysis Financial Specialist - Hemodialysis - FT - Day

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization.  As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed minimum pay reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

Minimum Pay:

$18.57

Position Overview

SUMMARY (Basic Purpose of the Job)

Provides guidance, instructions, information and counseling to ESRD outpatients in obtaining optimal resources for reimbursement to Capital Health of dialysis services. Responsible for obtaining and verifying registration, financial and insurance information pertaining to ESRD outpatients. Coordinates use of all reimbursement information with Business Office and Admission Office.

MINIMUM REQUIREMENTS

Education: High School diploma or equivalent.

Experience: Three years related experience in medical office or hospital setting. Experience with electronic health record preferred.

Other Credentials:

Knowledge and Skills: Intermediate knowledge of medical terminology, ICD-10 and CPT codes. Excellent verbal and written communication skills. Strong interpersonal and organizational skills.

Special Training: Proficient with Microsoft office applications.

Mental, Behavioral and Emotional Abilities: Ability to quickly change priorities when necessary to meet deadlines. Demonstrates good judgment as well as attention to detail. Ability to function as a team member and appropriately seek supervision as needed. Ability to work independently and be self motivated. Ability to maintain confidentiality of patient information. Ability to interact with all levels of staff in a courteous and professional manner.

Usual Work Day:8 Hours  

Reporting Relationships

Does this position formally supervise employees? No

If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.

ESSENTIAL FUNCTIONS

• Interviews patients/family to acquire registration, financial and insurance information. Provides individualized assistance to patients, families and caregivers to help overcome potential barriers such as lack of insurance, financial issues, managing health care expenses and any other financial related problems that may arise during treatment.
• Validates insurance coverage, determines priority of payer and acquires identification, signatures, pre-certifications and/or authorizations for services that will facilitate processing claims by payer and facilitates maximum utilization, efficiency, and minimal procedure-related problems.
• Discusses, instructs and explains to patient procedures and guidelines for coordination of benefits, optimizing insurance coverage and/or payment of dialysis-related bills. Advises patients of and obtains all necessary pre-certification and referrals needed for financial reimbursement. Assists patient, family and caregiver with understanding of their insurance coverage specific to their treatment and related services.
• Acts as a financial liaison between patient, insurance companies, physician offices and Business Office to discuss issues, resolve coverage and/or payment problems. Troubleshoots any issues related to financial integrity and accuracy of documentation and/or insurance requirements of account. Resolves these issues with internal departments and external offices.
• Provides necessary information and support to Business Office and/or Medical Records with acquisition of pertinent patient information required for payment of services. Works in conjunction with all members of patient's medical care team. Works closely with other medical team members to be a resource for team member and patient.
• Collaborates with Quality Insights Renal Network 3 in reference to submission of Federal/State required patient information relative to enrollment into ESRD program and changes in patient status.
• Works with Director of Renal Dialysis Services/Nurse Manager on patient acceptance into or transfers out of program. Assesses financial needs of new an