Description :

1. Acted as a liaison between the facility and the uninsured, underinsured, and/or patients with large outstanding balances to assess the patient's needs for financial assistance.
2. Identified any available assistance programs as well as screens and evaluates the patient's ability to pay and coordinates a mutually acceptable payment plan.
3. Educated the patients on the cost of care and assists them in the management of their financial responsibility.
4. Interview qualified patients for various potential funding sources and completes all necessary applications or paperwork for potential coverage(s) identified.
5. Problem-solved with all parties as necessary to help address insurance coverage gaps via alternative funding options.
6. Provided information regarding internal and external assistance programs and assists with the process.
7. Updated hospital and clinic patient accounting information system with appropriate information.

Experience

7-10 Years

Level

Management

Education

GED

Description :

1. Responsible for counseling patients and families, and facilitating the resolution of patient billing issues making mutually satisfactory payment arrangements.
2. Problem solved with all parties as necessary to help address insurance coverage gaps via alternative funding options.
3. Investigated and responded to all phone and written inquiries from patients/guarantors, insurance companies, and physician offices regarding estimated cost of services for Aurora patients.
4. Placed calls to outside sources for additional information to ensure that inquiries are resolved in a timely manner with the highest degree of accuracy and courtesy.
5. Worked cooperatively with other departments, physicians, third party payers, government officials, patients and their families with an emphasis on identifying any potential patient out-of-pocket expenses.
6. Assisted in verification of proper CPT and diagnosis coding is entered in the practice management system based on the level of service provided and documented in the electronic health record by provider.
7. Communicated with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims.

Experience

10+ Years

Level

Senior

Education

Bachelor Of Science

Description :

1. Interviewed qualified patients for various potential funding sources and completes all necessary applications or paperwork for potential coverage(s) identified.
2. Notified affected department as appropriate.
3. Acted as a liaison between health services and the consumer to provide education on costs, funding possibilities and payment options. 
4. Educated consumers on the cost of care and assists them in the planning and management of their financial responsibility.
5. Pre-screened self-pay patients to determine if they are eligible for coverage programs and assists patients or family members with completing financial assistance applications, as necessary.
6. Calculated and provided patients with personalized estimates of their financial responsibility based on their insurance coverage prior to service.
7. Communicated patient liability clearly and accurately while adequately explaining concepts such as deductibles, coinsurance, and/or copayments and how they may affect the cost of care. 

Experience

5-7 Years

Level

Executive

Education

MS

Description :

1. Conducted interviews with patients by phone and in person to negotiate payment schedule to assure account balance will be met.
2. Processed financial applications for approval and submitted for account write offs and or adjustments.
3. Identified Medicaid eligibility to vendor and make placement.
4. Officiated onsite financial orientations for patients to attend and educate the financial program for assistance.
5. Scheduled, rescheduled, and canceled appointments as necessary.
6. Programmed used are QuadraMed, ORSOS, Net Access, and other softwares to identify patients needing to be contacted on a daily basis for financial clearance.
7. Explained how non-covered and out-of-network services factor into the out-of-pocket cost.

Experience

5-7 Years

Level

Junior

Education

Diploma

Description :

1. N M Researched patient accounts to insure data was up to date and accurate, Note patient accounts with balances owed.
2. Input data and keep running spread sheet daily of amounts collected for end of week reports.
3. Communicated with insurance companies regarding benefits and payments & denials.
4. Made necessary corrections to billing for resubmitting claims.
5. Corrected insurance information to insure proper billing.
6. Counseled clients regarding their financial responsibility.
7. Answered insurance questions and setting up payment plans per company policy.

Experience

2-5 Years

Level

Executive

Education

MS

Description :

1. Requested upfront payment toward self-pay amounts, including estimated out-of-pocket costs and outstanding previous balances. 
2. Established payment arrangements in advance of scheduled services when applicable, communicating due dates and the amount of each installment.
3. Interviewed uninsured patients to assess for qualifying financial needs. 
4. Identified available assistance programs and coordinates with patient to complete paperwork and applications for any potential coverage(s). 
5. Continued follow-up efforts to obtain a funding source for patients health services.
6. Initiated credit scoring to determine each patients eligibility for Medicaid, hospital-sponsored charity care, and other programs through a comprehensive patient interview.
7. Demonstrated working knowledge of insurance benefits, insurance companies, and Marketplace insurance options, and stays informed of other payer sources entering the markets.

Experience

5-7 Years

Level

Executive

Education

MS

Description :

1. Conferred with guarantor/patient, Medical Staff and other hospital/clinic personnel in order to ensure prompt and full payment on accounts.
2. Documented all conversations and actions taken into the Practice Management System.
3. Accepted payment by phone and established payment arrangements according to established policies.
4. Worked with collection agencies and virtual liaison to resolve account balances.
5. Received and routed all miscellaneous calls.
6. Updated demographic insurance information into the billing system as appropriate.
7. Educated physician office/patient on the organizations applicable policies such as Financial Assistance Policy, Patient Financial Responsibility, Non-Covered Services, and Deferral of Care. 

Experience

7-10 Years

Level

Management

Education

MS

Description :

1. Helped qualify for medical cards.
2. Approved financial assistance.
3. Kept accounts current.
4. Set up payment plans.
5. Accepted payments.
6. Responsible for filing patient medical insurance and accurately posting insurance payments.
7. Achieved a 95% collection rate on all insurance claims and billings.

Experience

7-10 Years

Level

Management

Education

High School Diploma

Description :

1. Provided follow up services for other Wheaton Fraciscan locations and patients.
2. Courses included the following; HIPAA Training and Compliance, Customer Service, Communications (including proper phone and email etiquette) and Support, Health Insurance Exchange, Patient Privacy and Confidentiality Rights.
3. Counseled all in-patients (15-20) daily on medical treatment costs, insurance benefits, and medical billing process (deductible, co-insurance, out of pocket max).
4. Collected balances owed by patients.
5. Generated value to employer and to patients by coordinating patient applications and processing paperwork needed to apply for additional benefits (Medicaid, Medicare, and Social Security Disability).
6. Interfaced with patients and insurance companies to resolve discrepancies and/or wrong CPT or diagnostic codes on insurance claims.
7. Coordinated with provider office to determine scheduling options based on the need to secure funding and clarify patients financial responsibility.

Experience

5-7 Years

Level

Executive

Education

MS

Description :

1. Discussed insurance benefits and payment options.
2. Maintained office hours for billing disputes, claims, and general inquires.
3. Liaison to county offices for appropriate Medicaid claims.
4. Implemented the department at a newly acquired hospital and established their office routines, policies, and procedures.
5. Used Analytical, problem solving, customer service.
6. Worked in conjunction with state social worker and/or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients eligibility.
7. Understood and complied with all internal charity care policies and processes. 

Experience

10+ Years

Level

Senior

Education

Bachelor Of Business Administration