Patient Financial Representative (Fulltime)

Houston Behavioral Healthcare Hospital•Houston, TX

21h•Onsite

About The Position

Houston Behavioral Healthcare Hospital is recruiting for two Fulltime Patient Financial Representative positions. The Patient Financial Representative will report to the Business Office Manager (BOM). The patient financial representative is responsible for all business office functions, including admitting activities for the patients, financial counseling and collection, data analysis, and eligibility determination. This role requires knowledge of governmental and managed care payer requirements and involves implementing policies and procedures for patient admission/registration. The position ensures daily census accuracy, completes required admission forms, and acts as a liaison between patients and their insurance companies to coordinate payments and answer questions. The representative will educate patients on payment options and financial assistance, verify insurance benefits, and register patients using AIS software. Knowledge of Behavioral Health carve-out insurance and prior authorization/coordination of benefits is essential. The role involves following up with patients on Out of Pocket collections, entering accurate documentation into the system, and ensuring all collection activities comply with State and Federal laws. Additionally, the position reviews self-pay balances, processes refunds, and works effectively with Assessment & Referral and Case Management staff to maximize collections and minimize clinical denials. Participation in training programs and upholding organizational ethics and customer service standards are also key aspects of this role. The representative will conduct detailed discussions with patients to determine eligibility for Medicaid and other government or private sources, assist with financial interviews, file Medicaid applications, and educate patients/families about payments.

Requirements

High School, GED or equivalent required.
Knowledge of governmental and managed care payer requirements.
Knowledge of Behavioral Health carve out insurance and prior authorization/coordination of benefits.
Ensures all collection activities are in compliance with State and Federal collection laws.
Ensures compliance with hospital policies and procedures and is knowledgeable and compliant with all applicable Federal and State requirements.
Upholds the Organization's ethics and customer service standards.

Nice To Haves

College degree preferred.
1 year admitting and/or Financial Counseling in behavioral health setting preferred.
Hospital De-escalation Certification (Upon completion in Orientation)

Responsibilities

Responsible for all business office functions, including admitting activities for the patients, financial counseling and collection, data analysis, and eligibility determination.
Implement policies and procedures for admission/registration of all patients.
Ensure that daily census is accurate, in both paper and system formats.
Complete all required forms for admission/registration of a patient and/or patient's family.
Act as the liaison between patients and their insurance companies; often coordinating payments and answering questions from both parties.
Educate patients about payment options and financial assistance.
Verify insurance benefits and register patients using AIS software.
Follow-up with each patient on their Out of Pocket collections.
Enter complete and accurate documentation into the system describing all patient related admitting/registration activities.
Fully document all transaction requests into the system.
Ensure all collection activities are in compliance with State and Federal collection laws.
Review all self pay balances with credit balances to ensure the balance is accurate and processes all refunds (both by check and credit card) for approval in a timely manner.
Work effectively with Assessment & Referral staff to maximize all pre-admission activities.
Work effectively with Case Management staff to minimize the potential for clinical denials.
Work effectively to maximize the overall collection efforts of the hospital.
Participate in training programs to ensure activities are effective.
Ensure compliance with hospital policies and procedures and is knowledgeable and compliant with all applicable Federal and State requirements.
Uphold the Organization's ethics and customer service standards.
Conduct detailed discussion with patients, obtain information and complete required tasks to determine patient’s eligibility for Medicaid and other federal, state, and local government or private sources as appropriate.
Aid in financial interview for Medicaid application process, file Medicaid application, and educate patients/families about payments and requesting signatures.
Perform related duties as requested.