Patient Accounts Rep

Brown Medicine•Cranston, RI

1d•$19 - $31•Onsite

About The Position

Under the general supervision of the Supervisor and in accordance with established policies and procedures, the Patient Accounts Rep interviews, pre-registers, registers, and admits patients. The role financially clears accounts for Admissions and other Ambulatory Departments by collecting demographic, third-party insurance, and related financial information in LifeChart. The representative initiates, reviews, and follows up on patient accounts to support accurate billing, checks prior hospital balances, requests deposits based on estimated charges or applicable copayments and coinsurance, arranges payment agreements, and refers patients to Patient Financial Advocates when appropriate. The role also makes preliminary determinations of welfare eligibility and/or eligibility for the RIH Financial Assistance program and verifies demographic and insurance information, obtaining or applying for referrals and authorizations as required by hospital policy. Employees are expected to model Brown University Health's values of Compassion, Accountability, Respect, and Excellence, and demonstrate the core Success Factors: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate.

Requirements

High school education or equivalent level of knowledge.
Well-developed interpersonal and communication skills to obtain patient information and communicate effectively with the public in person and by phone.
Ability to respectfully establish payment arrangement terms and collect payments.
Knowledge of third-party health insurance authorization and validation.
Minimum of two years of experience in a hospital, physician setting, or health insurance company.

Nice To Haves

Epic ADT/Cadence and/or billing experience.

Responsibilities

Interview patients, representatives, and families to obtain complete and accurate personal and financial information, and follow up on missing data with patients, employers, nursing homes, and other facilities.
Use multiple systems to validate health insurance, obtain authorizations, and determine patient financial liability.
Contact patients and families to complete pre-admission demographic and financial information, including copayments, deductibles, coinsurance, and outstanding balances.
Complete Medicare Secondary Questionnaires, liability information, and other applicable documentation.
Validate insurance through Passport, payer websites, or direct calls to insurance companies.
Obtain authorization for inpatient, observation, and selected outpatient services; contact patients and physicians when authorization is denied.
Review outpatient and observation pre-admission Medicare cases for appropriate patient class under Medicare status “C” regulations, following up with physicians when necessary.
Validate Advance Beneficiary Notices for selected outpatient services for Medicare patients and coordinate with physician offices to verify selected procedures.
Obtain appropriate authorization for in-house patient class changes and explain changes in financial responsibility to patients on nursing units.
Follow up on missing information and unsigned ED admission documents by visiting patients on nursing units.
Meet with Medicare patients who have exhausted inpatient coverage days to explain Lifetime Reserve Day options and arrange payment if they decline to use those days.
Validate managed-care enrollment and obtain authorization for in-house patients with RI Medicaid or Mass Health plans; validate all in-house patients' insurance on the first of each month.
Complete pre-admission testing registration, including demographic and financial information, welcome materials, and Advance Directives.
Complete direct admissions on nursing units.
Refer self-pay patients to a Medicaid Specialist or Patient Financial Advocate.
Complete applicable waivers for non-covered services and lack of authorization at the time of service for non-Medicare payers.
Coordinate daily admission reports for payers.
Greet and direct patients, families, and visitors promptly and courteously.
Scan patient identification, take patient photographs, and obtain signed patient agreements.
Explain patient consent and agreements and obtain required signatures in accordance with admission and registration policies.
Provide and review the HIPAA Privacy Notice, Ethics brochures, Patient Rights, Hospital Directory, Advance Directives, Rhode Island Hospital Welcome Brochure, and other related information.
Prepare and apply patient identification bracelets.
Explain applicable non-covered-services and no-authorization waivers.
Document information in LifeChart, log payments under the Over the Counter Policy, and provide receipts in accordance with department policy.
Use LifeChart and Business Office reports to complete daily work, communicate with service departments to obtain physician order information, and use department systems and equipment as required.
Attend and participate in staff meetings.
Protect and preserve patient privacy and confidentiality.
Perform other duties as required or assigned.