UnityPoint Health

  • Patient Financial Coordinator

    Requisition ID
    2018-49273
    Category
    Billing and Coding
    Location
    US-IA-Sioux City
    Address
    2720 Stone Park Blvd
    Affiliate
    7520 UnityPoint Heath SC St Lukes
    City
    Sioux City
    Department
    Revenue Cycle
    State
    IA
    FTE
    .50
    FLSA
    Non-Exempt
    Scheduled Hours/Shift
    8:00 am -4:30 pm M-F every 4th week end
    Work Type (Portal Searching)
    Part Time Benefits
  • Overview

    UnityPoint Health - St. Luke's

    Shift: Part-time with benefits. Shift is flexible.

     

    The PFC/CAC assesses patients’ financial and insurance information in order to determine Medicaid, Marketplace, or other Community Programs or Resources.  Assists with the actual insurance enrollment processes.  Manages accounts that require a detailed, large scope analysis of payment/insurance options in order to secure reimbursement.  Handles active, unbilled, self-pay and high dollar inpatient and outpatient accounts.  Receives account referrals from Pre-access Department, Utilization Review Staff, Patient Access Staff, Physicians, Central Business Office Managers and others for high deductible, out-of-pocket expenses, unresolved or pending claims, out-of-network procedures and other financial risk issues.  Counsels’ patients that have previous debt, with poor payment history, are unresponsive or uncooperative in implementing appropriate payment solutions.

    Responsibilities

    Essential Functions/Responsibilities:

     

    Patient Financial Coordinator/Counselor     -        

    • Meet with patients that are identified as self-pay or underinsured to obtain insurance coverage if applicable, and/or review prior account information to obtain insurance coverage information. Notify appropriate department of information and document appropriately in the electronic record.
    • Educate, screen, and assist patients who do not have valid insurance coverage to enroll in programs including, but not limited to state and federally funded assistance programs.
    • During interview process, educates patients on applicable policies such as Point of Service (POS) collection, payment options, and financial assistance.
    • Establish payment arrangements for patients per established policies.
    • Research, identify, and rectify any special circumstances affecting delayed payment of self-pay accounts.
    • Works in conjunction with outside eligibility vendor to ensure the appropriate completion of Medicaid applications and monitors the status.
    • Review patient’s financial status to determine the eligibility of funding (including FINA and COBRA) and assists in completing necessary paperwork for assistance determined.
    • Follow-up on outstanding funding applications.
    • Financially clears patients prior to service by ensuring insurance has been verified, and patient liabilities have been collected or established prior to service.
    • Works closely with other Patient Access Staff and Care Coordinators.
    • Responsible for all Inpatient and Observation patients in their area of responsibility, making sure the accounts are complete to insure timely billing. This includes the giving of the Medicare letters.
    • Performs other duties as assigned.

    Basic UPH Performance Criteria

    • Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
    • Demonstrates ability to meet business needs of department with regular, reliable attendance.
    • Employee maintains current licenses and/or certifications required for the position.
    • Practices and reflects knowledge of HIPAA, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
    • Completes all annual education and competency requirements within the calendar year.

    Qualifications

     

    Minimum Education

     

    • Bachelor’s Degree in a health related field preferred and two or more years of relevant healthcare experience.  Experience and knowledge in completing and submitting Medicaid and Marketplace applications desirable.

     

    Minimum Work Experience

     

    • Bachelor’s Degree in a health related field preferred and two or more years of relevant healthcare experience.  Experience and knowledge in completing and submitting Medicaid and Marketplace applications desirable.  Knowledge of complex Medicaid policies, including SSI related programs, procedures and QHP plans.  Knowledge of Medical Terminology preferred.  Strong computer skills required.

     

    Required Licenses/Certifications

     

    • Obtain (within 12 months of hire date),and maintain CMS Marketplace Certified Application Counselor Certification
    • Obtain (within 12 months of hire date), and maintain DHS Presumptive Certification for appropriate states.

     

    Required Skills, Knowledge, and Abilities

     

    • Strong computer skills required.
    • Knowledge of complex Medicaid policies, including SSI related programs, procedures and QHP plans. 
    • Knowledge of Medical Terminology preferred. 
    • Ability to perform a variety of tasks, often changing assignments on short notice.
    • Must be adept at multi-tasking and possess problem solving, critical thinking and time management skills.
    • Will be required to learn and work with multiple software/hardware products. 
    • Must possess excellent listening, and communication skills, and demonstrate courteous and dependable work performance.

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