Coordinator: Hospital Discounted Care

Pagosa Springs Medical Center•Pagosa Springs, CO

7d•Onsite

About The Position

This position helps patients navigate healthcare costs and financial assistance while ensuring Pagosa Springs Medical Center's Hospital Discounted Care program remains accurate, timely, compliant, and patient-centered. It is ideal for an experienced healthcare revenue cycle or patient financial services professional who enjoys combining patient advocacy, detailed case management, regulatory compliance, financial calculations, data accuracy, and cross-departmental coordination. The Coordinator manages the Hospital Discounted Care (HDC) process from account identification through screening, application, eligibility determination, payment-plan coordination, reporting, and audit support. This role serves as the central operational resource for ensuring uninsured patients, subsequently uninsured patients, and insured patients who request assistance receive timely, understandable, and properly documented access to available coverage and financial assistance options. The Coordinator works closely with Patient Access, Patient Financial Services, Revenue Cycle, Finance, Informatics, Health Information Management, applicable hospital-based professionals, Compliance, and PSMC's contracted HDC vendor. This position must also be comfortable adapting workflows, procedures, and responsibilities as Colorado's Hospital Discounted Care requirements evolve.

Requirements

High school diploma or GED
Associate's degree in healthcare administration, business, finance, social services, health information, or another related field, or equivalent directly related experience
Minimum of three (3) years of experience in healthcare revenue cycle, patient financial services, financial counseling, eligibility, benefits navigation, health information, or a closely related function
Experience managing detailed casework, deadlines, patient communication, and confidential information
Experience with Colorado Hospital Discounted Care, Medicaid or public-benefit eligibility, hospital charity care, or rural hospital revenue cycle
Experience with Oracle Health (Cerner) CommunityWorks, data reconciliation, regulatory reporting, audit preparation, or process improvement
Current AHA BLS certification for healthcare providers
Ability to accurately perform and explain income, percentage, payment-plan, and account calculations
Proficiency with electronic health records, billing systems, work queues, spreadsheets, secure file exchange, and Microsoft Office applications
Working knowledge of patient financial assistance, public coverage pathways, hospital billing, payment plans, collections, privacy, and documentation practices
Strong organization and follow-through when managing a high volume of time-sensitive patient accounts
Ability to interpret and consistently apply written rules, procedures, decision tools, and calculation guidance
Compassionate, respectful, and culturally responsive communication
Strong attention to detail, sound judgment, and problem-solving skills
Ability to recognize systemic workflow or data issues and identify when escalation is necessary
Ability to work independently while collaborating across operational, financial, technical, clinical, and compliance teams
Bilingual English/Spanish skills or demonstrated experience using qualified interpreter services

Nice To Haves

Bachelor's degree in a related field
Additional language skills beyond the minimum communication requirements

Responsibilities

Monitor designated EHR and billing work queues and other referral sources to identify potentially in-scope patient accounts.
Manage accounts involving uninsured, self-pay, subsequently uninsured, and insured patients requesting assistance.
Process screening referrals from hospital departments and ensure related encounters and services are linked to the correct patient record.
Maintain a complete HDC tracking log showing each account's screening, application, determination, outreach, payment-plan, billing, and collection-protection status.
Prioritize cases based on regulatory deadlines, discharge dates, billing status, patient needs, and risk of inappropriate collection activity.
Reconcile completed, pending, declined, unreachable, and returned accounts so patients are not lost between internal departments or external service partners.
Contact patients or authorized representatives using appropriate communication methods and required outreach practices.
Explain Hospital Discounted Care, public health coverage, PSMC financial assistance, application requirements, patient rights, deadlines, payment-plan protections, appeals, and complaint processes in plain language.
Complete or coordinate required screening for public health coverage and discounted care.
Provide application assistance or referral support for programs such as Medicaid, Emergency Medicaid, CHP+, Medicare, marketplace coverage, and other applicable programs.
Obtain and maintain required screening-decline documentation.
Document Patient Contact Best Efforts and other required outreach activity.
Coordinate qualified interpreter services, accessible communication, and reasonable accommodations when needed.
Initiate and manage HDC and related financial assistance applications.
Request only information and documentation permitted under current requirements.
Track outstanding documentation and communicate missing information to patients.
Verify household composition, income, insurance status, dates of service, and supporting information using current methodology and PSMC policy.
Calculate federal poverty guideline percentages, discounted-care eligibility, patient liability, and maximum monthly installment amounts.
Complete determinations within delegated authority and escalate exceptions or complex cases appropriately.
Prepare and send timely approval, denial, and other determination notices.
Communicate final eligibility, discounts, payor information, and account-adjustment information to applicable staff.
Refer patients who do not qualify for HDC to other PSMC financial assistance processes when appropriate.
Establish or coordinate compliant HDC payment plans using approved calculations.
Explain payment plans and required documentation to patients.
Monitor active payment plans, payments, deferment or redetermination requests, missed payments, completion, and required balance adjustments.
Coordinate account corrections, credits, refunds, write-offs, collection holds, and recalls when screening or eligibility information changes.
Perform or document required pre-collection reviews.
Confirm screening, outreach, discounted rates, payment-plan protections, notices, third-party billing, and applicable waiting periods have been satisfied.
Prevent accounts from advancing to prohibited collection activity when required HDC documentation or patient protections are incomplete.
Promptly escalate exceptions or potential patient-impact concerns.
Maintain complete, accurate, confidential, and retrievable HDC records.
Ensure applications, screening and decline forms, outreach logs, supporting documents, calculations, notices, account adjustments, payment plans, collection reviews, appeals, and remediation documentation are properly maintained.
Apply required record-retention standards and protect confidential patient and financial information.
Compile and validate annual HDC reporting data.
Reconcile reportable populations and reporting totals to source systems.
Research missing, conflicting, or incomplete information with Revenue Cycle, Finance, Informatics, HIM, applicable professionals, and vendors.
Maintain supporting documentation for final submissions, corrections, and regulatory review.
Prepare audit samples and supporting evidence.
Assist Revenue Cycle leadership and Compliance with findings, corrective actions, patient-impact reviews, and effectiveness monitoring.
Monitor and report overdue work, documentation gaps, trends, and patient-impact concerns.
Serve as a primary operational resource for HDC questions.
Coordinate with external resources as authorized by leadership.
Maintain current procedures, forms, scripts, job aids, work queue logic, standard letters, and staff instructions.
Train and support Registration, Patient Financial Services, billing, collections, case management, and other affected staff.
Participate in system and workflow testing.
Verify automated statuses, due dates, letters, interfaces, holds, reports, and escalation alerts operate appropriately.
Identify barriers involving patient access, timeliness, language access, documentation, billing accuracy, or reporting.
Recommend practical process improvements.
Maintain backup procedures and cross-train designated staff to ensure time-sensitive HDC responsibilities continue during absences.