Patient Financial Specialist 8:30am - 5pm (Weekends Required)

Prisma Health•Seneca, SC

21h•Onsite

About The Position

Performs in-depth demographic and financial assessments, often at the bedside, to determine appropriate payor sources. Responsible for collecting deductibles, co-pays, and co-insurances, as well as payments towards self-pay accounts. This role involves assisting patients with financial needs and contacting external agencies like Vocational Rehabilitation, Department of Health and Human Services, and Social Security Administration. The specialist partners with Social Work and Outcomes Management to ensure the most appropriate continuum of care for patients.

Requirements

High school diploma or equivalent OR post-high school diploma/highest degree earned
Three (3) years health care revenue cycle experience (such as Billing, Collections, and/or Customer Service)
Ability to obtain and maintain knowledge of computer systems and financial counseling processes.
Ability to exercise judgment in analyzing information and following through on accounts.
Superior interpersonal relationship skills for developing and maintaining positive professional relationships.
Superior revenue cycle knowledge through ongoing review of regulations and guidelines.
Ability to work in accordance with Patient Friendly standards.

Nice To Haves

Bachelor's degree and three (3) years of experience in a service industry may be considered in lieu of education and experience requirements.

Responsibilities

Interviews patients and/or their representatives to obtain complete and accurate demographic and financial information, adhering to HIPAA guidelines.
Assesses patient accounts to determine appropriate payor sources and ensures collection of patient financial responsibilities.
Assists patients with financial needs and contacts outside agencies for financial assistance.
Partners with Social Work and Outcomes Management to ensure appropriate patient care continuum.
Possesses and demonstrates knowledge of computer systems and financial counseling processes.
Analyzes collected information to ensure patients receive consideration for financial assistance.
Ensures elimination of all possible payor sources before considering hospital sponsorship.
Communicates estimated financial responsibility to patients and requests payment prior to or at the time of service.
Explains insurance terms to patients.
Receives payments and issues receipts in accordance with departmental cash handling procedures.
Monitors high dollar accounts for complete and accurate financial and demographic information for timely submission and reimbursement.
Initiates authorization and insurance verification processes and communicates changes.
Coordinates and delegates referrals to the Department of Health and Human Services for application completion.
Explores possible payor source options such as Cobra, Liability, Worker's Compensation, or other Governmental Agencies.
Contacts Social Security Administration and makes appointments for patients as needed.
Assists patients with interviews and completing required forms.
Facilitates the disability determination process by working with clinical staff and disability examiners.
Coordinates referrals to appropriate outsource vendors for cases requiring additional follow-up post-discharge.
Works in accordance with Patient Friendly standards and company policies.
Performs other duties as assigned.