Patient Fin Team Lead - Patient Access

Kettering Health Network•Hamilton, OH

12d•Onsite

About The Position

Patient Financial Advocate Specialist This individual is responsible for pre-screening and enrolling self-pay (uninsured and underinsured) patients for external financial assistance programs, with a primary focus on Medicaid. This individual is also responsible for assisting patients in the process of completing financial assistance applications, educating them about their financial responsibility, and helping them identify a path toward resolving their balances. This role involves communicating with patients both in person and over the phone, and requires a high level of customer service Pre-screens uninsured and underinsured patients bedside and through outreach to identify potential financial assistance opportunities. Assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs. Ensures financial assistance applications are accurately filled out and complete before approval. Staff coverage at other Kettering Health hospital facilities, when needed Works in conjunction with on-site state social worker or outside eligibility vendor to assist and complete the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility. Initiates comprehensive interviews to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs. Provides patients with personalized financial assessment-based KH financial program guidelines, Insurance coverage and estimated patient liability. Initiates payment arrangements, collect patient liability after financial assistance has been determined and applied. Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility. Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.) Coverage at other Kettering Health hospitals, as needed.

Requirements

High school diploma or GED required
At least two years of appropriate work experience that would indicate a high level of communication skills and organizational ability.
Broad knowledge of government Advocate programs, guidelines, and application procedures
Strong written and verbal communication skills
Ability to effectively translate medical and administrative language into more familiar terminology
Strong attention to detail
Ability to comply with procedural guidelines and maintain confidentiality

Nice To Haves

Financial counseling, eligibility screening, and/or Medicaid application processing experience strongly desired
Prior experience performing community outreach preferred
Familiarity with statutes and regulations that can impact financial conversations

Responsibilities

Pre-screens uninsured and underinsured patients bedside and through outreach to identify potential financial assistance opportunities.
Assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs.
Ensures financial assistance applications are accurately filled out and complete before approval.
Staff coverage at other Kettering Health hospital facilities, when needed
Works in conjunction with on-site state social worker or outside eligibility vendor to assist and complete the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility.
Initiates comprehensive interviews to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs.
Provides patients with personalized financial assessment-based KH financial program guidelines, Insurance coverage and estimated patient liability.
Initiates payment arrangements, collect patient liability after financial assistance has been determined and applied.
Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility.
Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.)
Coverage at other Kettering Health hospitals, as needed.