This position is responsible for providing personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research. This position partners with the clinical care team to determine financial impact for the patient and serves as the primary contact for any financial questions related to a patients care across the entire continuum of their treatment, ensuring a seamless experience for the patient and their family.
Performs pre-registration/registration processes. Partners with the clinical care team to determine initial authorizations needed based on the predicted care treatment plan. Obtains patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing, if necessary. Assesses need for alternative coverage sources.
Verifies insurance coverage and obtains authorizations and notifications throughout the patients treatment. Obtains all necessary signatures and documentation required by the patients insurance plan. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, preferred providers and changes in patients treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patients care and maximum reimbursement and minimized financial impact to the patient.
Provides financial counseling to patients and their families and serves as the primary resource throughout the patients treatment. Discusses benefits and other financial issues with patients and/or family members during initial referral and during continuation of care. Advises patients on insurance and billing issues and options. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients, families and team members in addressing insurance coverage gaps via alternative funding options.
Provides financial advocacy, assistance and support to patients and families, as needed. Assists patients who are un-insured to access other funding resources and completes required documents. Maintains current working knowledge of Medicare, Medicaid and other program benefits and criteria, particularly as they pertain to long-term care and low-income patients. May serve as a liaison between the facility and community in making community resources available to the patient and family.
Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence.
Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments.
May provide leadership and training to other members of the financial team and serves as a resource for internal and external customers.
Requires knowledge as typically obtained through an Associates Degree, with a focus in social work, healthcare administration or finance.
Requires knowledge of medical terminology and an understanding of all common insurance and payor types, authorization requirements and alternative financial resources as typically obtained through a minimum of three years of diversified experience in a hospital Patient Registration/Financial Services setting. Must have highly developed interpersonal, communications and human relations skills. Must also possess accurate and efficient keyboarding skills, strong organizational and time management skills and flexibility in responding to multiple demands.
Bachelors degree in social work, healthcare administration or finance preferred.Prior experience as a social worker or financial counselor preferred.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.