Financial Rep Access Dept

Palomar Health•Poway, CA

1d•$21 - $32•Onsite

About The Position

The Financial Rep Access position serves as the initial point of contact for patients and their families regarding funding options for both inpatient and outpatient services. This role is responsible for the daily tasks of securing funding for patients across various stages, including scheduling, pre-registration, registration, and post-registration. Key duties involve screening all admissions daily, educating referring physician offices, patients, and families on hospital policies and procedures concerning payment methods, and advising on pre-payment deposits and monthly payment arrangements. The representative obtains and documents current funding information or provides details on available funding sources if needed. Collaboration with all revenue cycle departments is essential to address issues, overcome barriers, and develop resolution plans. The role also entails collecting upfront payments for self-pay accounts, co-pays, deductibles, and co-insurance, as identified through insurance information or eligibility verification. The representative screens patients for potential third-party and charity eligibility, stays updated on admission/business office insurance procedures, and utilizes payer resources and websites to assess eligibility and initiate referrals for programs like MediCal/CMS/CCS. They are responsible for administering the Palomar Health Financial Assistance Policy and Procedures to determine eligibility for discounted services or charity care, and must be knowledgeable about AB774 to assist patients in qualifying based on federal poverty guidelines. The position requires careful financial evaluation of all admissions, making decisions beneficial to the hospital while showing consideration and empathy for patients and families during stressful situations. The individual must be firm, decisive, courteous, tactful, considerate, keen, alert, and capable of effective communication with diverse educational backgrounds, possessing the knowledge and confidence to make payment method decisions despite frequent interruptions. The role also involves performing other assigned duties, adhering to Palomar Health rules, policies, procedures, applicable laws, and standards, and upholding the mission, vision, and quality commitment of Palomar Health.

Requirements

High School Diploma and/or combination of education and experience
2 years Patient Access and/or Patient Financial Services experience assisting patients with insurance and government funded programs
Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position.
Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail).
Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job.

Nice To Haves

High School Diploma and/or combination of education and experience plus 1 year healthcare-related experience or basic college/medical coursework to learn medical terminology
3+ years Patient Access and Patient Financial Services experience assisting patients with insurance and government funded programs, including experience related to billing and payment of government funded health plans.
Bilingual (Spanish)
Certified Healthcare Access Associate (NAHAM)

Responsibilities

Serves as the first contact for patients and families regarding funding sources for inpatient and outpatient services.
Responsible for the day to day activities of obtaining funding for patients in the statuses of scheduling, pre-registration, registration, or post registration as assigned.
Screens all admissions on a daily basis and educates referring physicians offices, patients and their families on hospital policy and procedures regarding various methods of payment source for services rendered.
May include advising applicable admits of pre-payment deposits and monthly payment arrangements.
Obtains and documents information that appropriately designates current funding information and/or provides information on available funding sources if the patient/family does not have current sources.
Works in collaboration with all departments and units in the revenue cycle to appropriately communicate issues and/or barriers, and to formulate work plans for resolution.
Obtains appropriate up front collection on all self pay accounts as well as co-pays, deductibles, and co-insurance as identified in information provided by the patient's insurance card or through the eligibility and verification process.
Screen the patient for possible other 3rd party and charity eligibility and keep up-to-date on admission/business office insurance procedures.
Adept at utilizing payer resources and web sites to accurately explore and assess eligibility and successfully initiate referrals for MediCal/CMS/CCS.
Appropriately administers the Palomar Health Financial Assistance Policy and Procedures to determine if the patient is eligible for discounted prices for services or is eligible for charity care designation.
Well versed in policy and procedure that pertains to AB774 and is able to assist the patient/family in determining if they qualify based on federal poverty guidelines.
Responsible for careful financial evaluation of all admissions, taking appropriate steps that are most beneficial to the hospital, while giving the proper level of consideration to the patient.
Must be firm and decisive, yet courteous, tactful, considerate and show concern and empathy for the patient/family under often stressful situations.
Must be keen, alert and have the ability to effectively communicate with people from various education backgrounds.
Must have the knowledge and confidence to make decisions regarding methods of payment and have the ability to work with frequent interruptions.
Performs other duties as assigned.
Follows Palomar Health rules, policies, procedures, applicable laws and standards.
Carries out the mission, vision, and quality commitment of Palomar Health.