Job Description
Primary City/State: Gilbert, Arizona
Department Name: Billing Customer Service-PBI
Work Shift: Day
Job Category: Revenue Cycle
POSITION SUMMARY Independently provides financial counseling to patients in a personal interview at the point-of-service to obtain applicable patient financial and demographic documentation. Provides guidance to Patient Services staff to help manage patient flow throughout the intake process. Identifies potential Patient Financial Assistance & payment arrangements through internal or external patient financing programs. Acts as an advocate by providing information and support to help patients navigate the financial aspect of their laboratory services. Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
CORE FUNCTIONS 1. Advocates with patients during site intake process; appointment scheduling, registration (which includes entry of patient demographic information into Quanum), and assessment of patients' financial ability. On an as-needed basis, determines ability to pay, advises patients on insurance benefits, explains financial liability, collects payment, negotiates payment arrangements, secures financing, identifies funding sources and resolves any confusion the patient may have about their financial obligations to the facility.
2. Acts as a patient advocate & uses knowledge of internal processes and assistance programs for the purpose of patient education and referral.
3. Responsible for the accurate and timely verification of insurance benefits, to include: contacting patients and/or guardians to obtain additional insurance information, researching and maintaining an ongoing collective knowledge of HMO, PPO, Medicaid, Medicare, commercial health plans and self-pay processes. Communication may occur in-person, in writing or via phone.
4. Maintain appropriate documents, reports and records in order to comply with all relevant internal compliance, billing and organizational policies and procedures, as well as all applicable state, federal and local laws.
5. Provides relevant guidance to the site staff & informs site personnel on new & revised processes as they relate to the patient intake and payment collection process.
6. Establishes & maintains courteous, supportive and cooperative relations with patients and site personnel. Serves as a primary resource to patients and resolves patient concerns to include insurance and billing questions.
KNOWLEDGE, SKILLS AND ABILITIES - Ability to clearly and efficiently communicate complex issues using strong verbal and written aptitude.
- Working knowledge of billing, insurance, computer systems, and medical billing processes.
- Ability to prioritize and complete multiple tasks.
- Excellent communication skills, both written and verbal.
- Excellent organizational skills.
- Intermediate computer knowledge with various programs/software.
- Ability to work independently and accurately with high volumes of data and minimal supervision.
- Ability to effectively interface with patients, health plans, senior management staff and/or clients.
MINIMUM QUALIFICATIONS - High School diploma or equivalent.
- Two (2) years' of related experience in medical billing or in a healthcare/clinical laboratory setting.
- Two (2) years' of customer service experience in a customer facing role.
- Order entry experience with entering insurance/billing information.
- Must be able to work weekends.
PREFERRED QUALIFICATIONS - Associate's Degree in related field.
- Additional experience in medical billing and/or in a healthcare setting.
- Extensive knowledge of clinical laboratory operations.
- Additional experience in insurance collections including resolution of denials and the filing of claim appeals.
- Advanced working knowledge of Xifin.
- Comprehensive knowledge of ICD-10 coding, CPT coding, HCPCS coding, modifiers, and government and commercial payer guidelines.
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Job Tags
Local area, Shift work, Weekend work,