Employment Type:

Full time

Shift:

Day Shift

Description:

Responsible for coordinating reimbursement sources and other activities related to securing reimbursement for hospital services provided to patients who are either already admitted to the hospital, or who may be seeking to obtain services. Work with patients to ensure the hospital receives maximum payment for all services rendered, while assisting the patient with avenues of financial assistance available to them.  Educates and assists patients with understanding their insurance coverage and benefits / options, setting up payment arrangements, and collecting patient financial responsibilities. Assists uninsured or underinsured families with navigation of the process related to applying for the government sponsored healthcare resources and / or the hospital’s Financial Assistance program.   

 

ESSENTIAL FUNCTIONS 

 

Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. 

 

Performs analysis of current and future patient accounts to validate third party coverage and to determine what if any amount is patient responsibility. 

 

Conducts patient financial interviews to assist with the resolution of the patient’s account, and to ensure compliance with hospital financial resolution policies. 

 

Assists and educates patients with respect to available resources for medical coverage including the Insurance Marketplace, governmental programs, and financial assistance.  Distributes information and estimates for No Surprise Billing according to department standards. 

 

Provides information, education, assistance, and follow-up as needed to complete charity processing for assigned patients, as appropriate. 

 

Visits inpatients to advise patients and guarantors as to rights, responsibilities, and procedures with regards to payment for care. 

 

Collects patient payments and handles according to RHM policy. 

 

Performs follow-up by telephone and/or written correspondence with patients who have not completed their financial application process prior to receiving certain elective or routine procedures. 

 

Monitors all self-pay and Medicaid (MA) pending inpatient and observation patients daily to ensure active follow-up for insurance is in progress. 

 

Interacts and collaborates with numerous departments to resolve issues (i.e., Care Coordination, Admitting, Legal Department, Patient Accounts, Hospital Based Practices) and provide necessary information that will ensure hospital reimbursement for Third Party liability. 

 

Communicates routinely with patient access staff, and / or physician offices as needed regarding the financial status, and deposit resolution for patients seeking certain elective or routine procedures. 

 

Escalates unresolved financial matters and / or complaints to Supervisor/Manager in a timely manner. 

 

Obtains and records new personal, demographic, medical insurance information. Ensures that patient demographic and financial information is complete and accurate.  

 

Ensures excellence in customer service relations provided to patients, family members, coworkers, and providers. 

 

Other duties as needed and assigned by the Supervisor