Patient Financial Specialist Representative

Banner Health•Phoenix, AZ

52d•Onsite

About The Position

This position is responsible for providing personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research. This position partners with the clinical care team to determine financial impact for the patient and serves as the primary contact for any financial questions related to a patient's care across the entire continuum of their treatment, ensuring a seamless experience for the patient and their family. BNW is a small therapy practice for people with movement disorders. The volumes are low so the PFS will be doing referral management, scheduling, authorization and general office functions.

Requirements

Requires knowledge as typically obtained through an Associate's Degree, with a focus in social work, healthcare administration or finance.
Requires knowledge of medical terminology and an understanding of all common insurance and payor types, authorization requirements and alternative financial resources as typically obtained through a minimum of three years of diversified experience in a hospital Patient Registration/Financial Services setting.
Must have highly developed interpersonal, communications and human relations skills.
Must also possess accurate and efficient keyboarding skills, strong organizational and time management skills and flexibility in responding to multiple demands.
Employees working at Banner MD Anderson on the Banner University Medical Center Phoenix campus must possess a State of Arizona Department of Public Safety Level One Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. This is a requirement of the Whole Family Counseling Program held at this specific facility.

Nice To Haves

Bachelors degree in social work, healthcare administration or finance preferred.
Prior experience as a social worker or financial counselor preferred.
Additional related education and/or experience preferred.

Responsibilities

Performs pre-registration/registration processes. Partners with the clinical care team to determine initial authorizations needed based on the predicted care treatment plan. Obtains patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing, if necessary. Assesses need for alternative coverage sources.
Verifies insurance coverage and obtains authorizations and notifications throughout the patient's treatment. Obtains all necessary signatures and documentation required by the patient's insurance plan. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, preferred providers and changes in patient's treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patient's care and maximum reimbursement and minimized financial impact to the patient.
Provides financial counseling to patients and their families and serves as the primary resource throughout the patient's treatment. Discusses benefits and other financial issues with patients and/or family members during initial referral and during continuation of care. Advises patients on insurance and billing issues and options. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients, families and team members in addressing insurance coverage gaps via alternative funding options.
Provides financial advocacy, assistance and support to patients and families, as needed. Assists patients who are un-insured to access other funding resources and completes required documents. Maintains current working knowledge of Medicare, Medicaid and other program benefits and criteria, particularly as they pertain to long-term care and low-income patients. May serve as a liaison between the facility and community in making community resources available to the patient and family.
Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence.
Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments.
May provide leadership and training to other members of the financial team and serves as a resource for internal and external customers.
Works independently under general supervision, leads and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient's care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. This position is an integral part of the care team, as they serve as the primary contact for all financial aspects of the patient's care, both for internal and external customers. Internal customers include all levels of the clinical care team, as well as other administrative support positions throughout the facility and organization. External customers include patients and their families, physician office staff and third party payors.