JOB DESCRIPTION:
- Responsible for administering, understanding, and communicating financial policies and financial screening process to patients, patient's families, and legal guardians in a clinical specialty of the Emory Clinic, Inc. to secure maximum reimbursement through up front identification and collection of patient liabilities.
- Serves as a resource for staff and patients in need of making financial arrangements, account inquiries, account reconciliations including extensive auditing, acts as a liaison between PFS and clinic operations to resolve customer inquiries related to billing and customer satisfaction in a timely matter.
- Performs all aspects of insurance eligibility and benefits verification.
- Requires knowledge of Medicare, Medicaid and Third Party carriers and referrals and precertification procedures.
- Monitors in-house accounts to improve revenue and timely payment of claims.
- Complete cost estimates and follow guidelines associated with pre-payment process.
- Identify patients which requires early financial counseling intervention and coordinates with the supervisor and clinic managers the outcome via written and verbal communication.
- Maintains patient confidentiality; complies with HIPAA and compliance guidelines established by Emory Healthcare.
- Collects or completes payment arrangements for unpaid balances not covered by third party insurance or those having no coverage.
- Responsible for financially clearing patients prior to their visits by collecting payment or determining insurance eligibility.
- Performs other related duties as required.
- Provide financial counseling to satellite clinics for assigned sections when required.
- Ability to multi-task efficiently and work in a fast paced environment and has a strong attention to detail.
- Provide excellent customer service to include compassion and empathy while focusing on account resolution.
- Organizational and time management skills in order to maintain and prioritize daily work and follow up on accounts in a timely matter is required.
- Excellent interpersonal skills and the ability to successfully interact with internal and external customers at all levels is required.
- Employee may be responsible for other duties as assigned.
MIMINUM QUALIFICATIONS:
- High School Diploma or equivalent and minimum of 3 years healthcare experience required OR any combination of equivalent education and experience.
- Knowledge of Medicare, Medicaid, and other managed care payors (HMO, PPO, etc.)
PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.