Employment Type:

Full time

Shift:

Day Shift

Description:

Responsible for coordinating reimbursement sources and other activities related to securing reimbursement for hospital services provided to patients who are either already admitted to the hospital, or who may be seeking to obtain services. Work with patients to ensure the hospital receives maximum payment for all services rendered, while assisting the patient with avenues of financial assistance available to them. Educates and assists patients with understanding their insurance coverage and benefits / options, setting up payment arrangements, and collecting patient financial responsibilities. Assists uninsured or underinsured families with navigation of the process related to applying for the government sponsored healthcare resources and / or the hospital’s Financial Assistance program. 

ESSENTIAL FUNCTIONS

Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.

Performs analysis of current and future patient accounts to validate third party coverage and to determine what if any amount is patient responsibility.

Conducts patient financial interviews to assist with the resolution of the patient’s account, and to ensure compliance with hospital financial resolution policies.

Assists and educates patients with respect to available resources for medical coverage including the Insurance Marketplace, governmental programs, and financial assistance. Distributes information and estimates for No Surprise Billing according to department standards.

Provides information, education, assistance, and follow-up as needed to complete charity processing for assigned patients, as appropriate.

Visits inpatients to advise patients and guarantors as to rights, responsibilities, and procedures with regards to payment for care.

Collects patient payments and handles according to RHM policy.

Performs follow-up by telephone and/or written correspondence with patients who have not completed their financial application process prior to receiving certain elective or routine procedures.

Monitors all self-pay and Medicaid (MA) pending inpatient and observation patients daily to ensure active follow-up for insurance is in progress.

Interacts and collaborates with numerous departments to resolve issues (i.e., Care Coordination, Admitting, Legal Department, Patient Accounts, Hospital Based Practices) and provide necessary information that will ensure hospital reimbursement for Third Party liability.

Communicates routinely with patient access staff, and / or physician offices as needed regarding the financial status, and deposit resolution for patients seeking certain elective or routine procedures.

Escalates unresolved financial matters and / or complaints to Supervisor/Manager in a timely manner.

Obtains and records new personal, demographic, medical insurance information. Ensures that patient demographic and financial information is complete and accurate. 

Ensures excellence in customer service relations provided to patients, family members, coworkers, and providers.

Other duties as needed and assigned by the Supervisor/Manager.

Must be comfortable operating in a collaborative, shared leadership environment.

Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MINIMUM QUALIFICATIONS

High school diploma, GED or an equivalent combination of education and experience.

Minimum of three (3) years of experience working in Patient Access or Patient Accounting for hospital registration and / or hospital reimbursement services.

National certification in HFMA CRCR and/or NAHAM CHAA required within one (1) year of hire.

Knowledge of federal or state government agencies including but not limited to Medicare, Medicaid, VA or Charity Care programs, or patient management and healthcare accounts receivable within the healthcare revenue cycle.

Ability to communicate effectively with customers and simplifying complex information.

Experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievements of performance metrics.

Basic understanding of Microsoft Office, including Outlook, Word, PowerPoint, and Excel.

Excellent interpersonal skills are necessary in dealing with peers, internal and external customers.

Accuracy, attentiveness to detail and time management skills

Must be comfortable operating in a collaborative, shared leadership environment.

Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran