Job Description

Obtains accurate third party billing information. Educates and assists patients in regards to their insurance coverage as it pertains to their course of treatment. Facilitates revenue cycle reconciliation and reimbursement by working with all corresponding departments.

Job Responsibility

• Ascertains and verifies all third party billing information for inpatient admissions and outpatient registration as required.
• Uses various on line products (AIM, Soarian, AEOS, Allscripts, Legacy Series, Epaces, Transunion, Internet, etc.) to check eligibility.
• Verifies patient's third party coverage in order to determine the patient's liability by interviewing patient or their representative.
• Determines patient's potential eligibility for Medicaid and completes application in accordance with departmental policies and procedures.
• Follows up all incomplete patient's Medicaid applications either by verbal or written contract as required.
• Records and updates all Medicaid or self-pay activity on AEOS and Series/Soarian systems.
• Keeps patients and their representatives informed of their insurance status and assist them with any questions they may have.
• Utilizes NYSOH Marketplace tool to follow up with patients and Medicaid applications in progress.
• Maintains activity score standard set by the Manager Patient Access.
• Maintains quality score standard set by the Manager Patient Access.
• Required to maintain effective communication with the Manager Patient Access /Assistant Director.
• Determines patient eligibility for financial assistance and complete application accordingly.
• Inform patients of their financial responsibility if they do not have coverage and are ineligible for any assistance, and complete payment agreement as needed. May perform other duties of patient accounting and /or other patient financial services staff as needed.
• May be required to travel/visit other departments within the hospital or other hospital/sites located off campus.
• Trains and mentors new employees.
• Performs related duties as required.
• Must have schedule flexibility inclusive of working holidays, weekends, and various shift hours.

*ADA Essential Functions

PHYSICAL DEMANDS:

• Required to lift, carry, pull, and reach approximately 10-25 lbs at least twice daily
• Ability to file and retrieve files from or on top of file cabinets, shelves and transfer file boxes between six inches low and five feet high

Job Qualification

• High School Diploma or equivalent, required. Associates or Bachelors degree preferred.
• Ability to read and write English.
• Ability to type 40 wpm, edit and proof read business correspondence, computer routines and prepare reports.
• Knowledge of Word, Excel, email, billing applications and Internet required. Soarian and Legacy Series preferred.
• Minimum six (6) months financial counseling, medical billing or insurance verification in a healthcare facility, required.

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).