Sr Financial Assistance Specialist
Company: Renown Healthcare
Posted on: October 11, 2019
This position will perform Quality Reviews on applications,
insurance verifications and notifications of admission completed by
each specialist in the PFA Department for completeness and
accuracy. These reviews will occur periodically at random and on
all cases denied to ensure we have not missed opportunities due to
timelines or inaccurate processing. The Sr. Financial Assistance
Specialist will report results of the quality reviews regularly to
the Manager of the Patient Financial Assistance department.
Additionally the Sr. Financial Assistance Specialist will support
the department by training staff, answering questions as needed,
and monitoring workflows on a regular basis.
This position will also be a working lead and will perform full
Financial Specialist functions on applications for federal, state
and county programs, Medical Financial Hardship (MFH), insurance
verification and notification of admission for Renown. The
responsibilities of the Sr Financial Assistance Specialist includes
but is not limited to the following:
* Facilitate the application process for financial assistance with
all applicable and appropriate patients including pre-admission,
bedside visits while in-house, and follow up after discharge
through on site or field visits.
* Follow up with patients to obtain all supporting documentation
for each application process.
* Maintain documentation on all work activity for each patient
account in the appropriate systems.
* Maintain communication/correspondence with patients,
representatives, designated family members, appropriate Renown
staff and all government entities on all accounts served.
* Completes application summary forms for FAP Committee review and
* Monitors all cases processed for financial assistance and by the
FAP Committee to completion.
* Completes documentation to justify adjustments for processing by
the Central Business Office.
* Issues all decision letters to patients who apply forFAP.
* Ensures all patient co pay balances are collected as a result of
the FAP approval process.
* Accurately identify all insurance payer sources and payer order
* Verification of insurance eligibility and benefits
* Timely insurance notification
* Determining estimated cost of services being rendered
* Identifying and collecting patient financial obligation amounts,
i.e. co-payments, co-insurance, deductibles, etc.
* Provides weekly report of application, verification and
notificationdiscrepancies by PFA representative to departmental
leadership to be utilized for training purposes.
* Reports trends identified during QA processes to department
leadership to ensure maximization of reimbursement.
* Participates in development and deployment of department training
modules resulting from QA activities.
Nature and Scope:
This position is responsible to conduct quality reviews of
applications in addition to comprehensive financial screenings as
directed. These may be conducted in person or by telephone
interview, to identify all potential payer sources including
federal, state and county assistance programs, and follow through
with obtaining and processing the appropriate application(s) in a
timely manner. Whenever possible, the screening will be done prior
to admission. The employee is responsible to ensure this process is
expeditious, compassionate and patient friendly. This position is
accountable for timely coordination and accurate communication of
information relative to all aspects of the financial assistance
process, and for timely submission of applications to the
appropriate government entity.
This position will review applications, verifications and
notifications that are delayed or denied for appropriate processing
and education to ensure that accounts are financially secured and
reviewed avoiding any lost reimbursement to the health system. The
employee must use diplomacy in communicating effectively to
patients, guardians, family members, physicians and co-workers. In
addition, the employee is responsible to coordinate with the
interdisciplinary team, i.e. Case Management, Social Services,
Nursing, etc. to ensure a seamless admission and discharge process
occurs for all patients referred to the department. This position
is responsible to always exhibit the highest level of
professionalism in accordance with Renown Health's Values.
This position collects data regarding the accuracy and completeness
of all applications made by the PFA department to be used for
employee education purposes and to maximize reimbursement to the
health system. The employee will participate in the training
process, and will provide reporting to departmental leadership.
This position does not provide patient care.
The foregoing description is not intended and should not be
construed to be an exhaustive list of all responsibilities, skills
and efforts or work conditions associated with the job. It is
intended to be an accurate reflection of the general nature and
level of the job.
Minimum Qualifications: Requirements - Required and/or
Must have working-level knowledge of the English language,
including reading, writing and speaking English. Bachelor's degree
preferred. Bilingual candidates (Spanish) will be given preference.
Requires the ability to perform intermediate math skills.
Understanding of medical terminology. Annual continuing education
requirements exist for this position.
Requires, at a minimum, to have two years experience in commercial
medical insurance benefits and eligibility verification, Medicaid
screening, applications and/or eligibility, medical financial
counseling experience, medical claims processing knowledge,
hospital Business Office follow-up experience, and/or professional
office with customer service financial interaction experience.
Experience in an acute care hospital preferred.
Valid State of Nevada or California driver's license and ability to
pass Renown Health's Department of Motor Vehicle Report
Nevada Division of Insurance Exchange Enrollment Facilitator
Certification required. Nevada DWSS Hospital Presumptive
Eligibility Certification required.
Computer / Typing:
Must possess, or be able to obtain within 90 days, the computers
skills necessary to complete online learning requirements for
job-specific competencies, access online forms and policies,
complete online benefits enrollment, etc. Thorough knowledge and
proficiency with MSExcel and MSWord. Experience with EPIC system
Keywords: Renown Healthcare, Reno , Sr Financial Assistance Specialist, Accounting, Auditing , Reno, Nevada
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