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, assisting in appealing denials, and facilitating pre-certification. Perform all aspects of benefits verification, referral, precertification and other prior authorization activities for Physician, Outpatient and Inpatient services. Monitors in-house accounts to improve revenue and timely payment of claims. Identifies those which require early financial counseling intervention and coordinates with the supervisor and collection agencies in assignment of bad debt accounts. Collect or completes payment arrangements for unpaid balances not covered by third party insurance or those having no coverage. Performs other related duties as required. MIMINUM QUALIFICATIONS: High school diploma or equivalent and minimum of 1 year healthcare experience. Knowledge of Medicare, Medicaid, and other managed care payors (HMO, PPO, etc.) preferred.
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.