Patient Financial Services

Description:

Required:

• Minimum of one (1) year of experience in an admitting office, clinic, physician or insurance office performing patient registration and insurance verification required.
• Previous EPIC Prelude and Cadence experience a plus.

Special knowledge, skills, & abilities:

• Exceptional computer skills and the ability to quickly master multiple computer programs required.
• Knowledge of business and office machines such as: fax, telephone, computer/printer, copier; reception skills required.
• Must have strong interpersonal skills and the ability and desire to work in a very busy, multidisciplinary setting.
• Must have good clerical skills, including typing (60 wpm) and excellent telephone etiquette and good organizational and record-keeping skills.
• Must have the ability to hold information in confidence.
• Must have appropriate manner, conduct and grooming and present a professional image.

Responsibilities Function:
1. Incoming and Outgoing Referral Processing:

• Routine Referral request management includes but isn't limited to
• Completes and processes all authorizations and referrals ordered
• Accurately obtains and/or verifies referrals and obtains pre-authorization or renewal of authorization as needed to ensure financial reimbursement for services provided by the department
• Ensures authorization number, if needed, is accurately recorded in Epic
• Ensures diagnosis and ICD-10 codes are provided with the referral and accurately entered into Epic Coordinates outgoing referrals by compiling necessary documents to be sent to external specialists
• Completes EMR Documentation of:
  1.Authorizations
  2.Denials
  3.Patient contact
• Communication to patient by letter, by phone, or by MyChart
• Contacting insurance companies, to solve and expedite referral processing barriers
• Communication with patients to clarify and/or update insurance information
• Communication to resolve referral locations
• Communication to resolve insurance concerns
• Verify insurance benefits, uses available systems and tools (HDX, PhTech, etc.) to determine eligibility, and completes MSPQ, as needed.
• Processing medical records as necessary to complete referral;
• For urgent referrals, communicates with specialty offices and insurance companies to expedite the appointment and authorizations
• Facilitates needs of patients and referral sources by keeping abreast of all services offered in the assigned department and discussing unusual requests with Supervisor or Manager. Communicates professionally to referral sources.
• Respond to provider questions and concerns for referral placement and processing. Maintains referral resource directory
• Maintains knowledge of primary and specialty practices: services, expectations for referrals, restrictions for referrals;
• Maintains knowledge of Managed Care requirements for referrals.

2. Work queues, RightFax, and Epic In-basket Assignments Ensures all external lab and imaging are sent to the correct place of service

• Verifies order is correct to allow for scanned return results are associated with the order
• Rightfax (referral fax Outlook mailbox)
• Completes work queue assignments within appropriate timeframes and assists others in completing work queue assignments as time allows.

3. Scheduling, Registration, Check-in and Phones Schedules patients for visits and/or procedures in such a manner to allow the department to run efficiently, with minimal patient wait time.

• Greets patients and visitors. Directs patients and visitors to appropriate areas. Provides direction and information regarding various programs and services. Follows established policies and procedures during patient registration and pre-registration with a high degree of accuracy.
• Collects co-pays, co-insurance and payments on past due accounts, and utilizes credit card applications correctly.
• Balances cash drawer and prepares deposits according to department protocol.
• Works with Professional and/or Hospital Billing Services, Charity Care and other resources to assist patients with payment plans.
• Follows appropriate check out processes, informing patient of follow up activities and/or re-scheduling, as needed.
• Screens and directs calls, takes and relays messages.

ATD Technology, LLC is a certified minority woman owned business that creates opportunities to match qualified individuals with client programs while meeting all parties' financial and technical goals. ATD is a full service provider with offerings in Contract, Permanent and Temp-to-Perm staffing solutions. We serve Fortune 1000, mid cap and small cap companies in the Commercial, Public and Government sectors.