DSHS ESH Financial Recovery Enforcement Officer 2
About The Position
DSHS ESH Financial Recovery Enforcement Officer Are you knowledgeable about financial applications or have a financial background? Do you have the patience and compassion it takes to interview and communicate with behavioral health patients in a professional manner? Join our eligibility determination team charged with investigating and determining financial responsibility for patients admitted to Eastern State Hospital and for ESH patients placed into community programs. We need your expertise to provide technical direction and training to Financial Recovery Enforcement Officers and other personnel. In this role, you will provide direction and assistance to patients and their payees, guardians, family members, Pharmacy, Social Workers, Office of Financial Recovery, Home & Community Services, Managed Care Organizations, Social Security Administration, and Disability Determination Services.
Requirements
- One year as Financial Recovery Enforcement Officer 1.
- OR 5 years of experience in the collection of civil debts, adjustment of claims, determination of financial responsibility, or investigation of financial backgrounds.
- Ability to interview and communicate with mental health patients in a professional manner.
- In-depth knowledge of the eligibility requirements for Medicare, Medicaid, and Social Security.
- In-depth knowledge of Federal and State programs and their applicable laws, rules, regulations, policies, and directives.
- Ability to comprehend and present complex laws, regulations, and programs and their relationships to a diverse audience.
Responsibilities
- Establish admission information, research patient benefits/insurance/assets, scan admission documentation to OFR HQ, and create an inpatient admission folder.
- Identify, establish, and pursue third-party benefits from private and public sources and pursue third-party sources of recovery such as private and group insurance, self-funded insurance programs, government-funded health insurance and benefit programs, and certain tort claims.
- Coordinate between OFR/Residential Billing Unit and Eastern State Hospital, patients, their families, payees or guardians, and attorneys to explain state and federal regulations regarding patient financial obligations Social Security Rules, and/or insurance benefits.
- Interview patients, family members, and other professionals to research and investigate patient financial situations and potential third-party insurance benefits to ensure timely notification of the admission to the insurance company.
- Apply state/federal medical benefits program criteria to individual patient situations and complete DSHS Medicaid applications, to help the patient pay for the cost of care.
- Perform monthly audits on Financial Recovery Enforcement Officer caseloads to measure employee performance and develop metrics to provide data to managers for assistance in the development of the revenue cycle.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
