PFS Representative - Inpatient

Mary Free Bed Rehabilitation Hospital•Grand Rapids, MI

1d•Onsite

About The Position

Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes. The growing Mary Free Bed Network provides patients throughout the state with access to our unique standard of care. The mission is restoring hope and freedom through rehabilitation. At Mary Free Bed, the culture is values-based, focusing on patient care with a selfless drive to serve and heal. Employees experience clinical variety and challenge through an inter-disciplinary approach and a top team of professionals. The organization offers the stability of a large organization while nurturing a family/team atmosphere, fostering trust among co-workers to make the right decisions for patients, staff, and community. There is a proud tradition of dedicated, quality service to patients and the community, yielding a reputation that fills employees with pride. The organization is committed to putting everybody in motion, fueled by a passion for innovative, integrated rehabilitation care, with teams working together to elevate everyone’s potential. Every role, from ensuring a safe environment to providing clinical care or helping patients navigate appointments, is united by the mission to restore hope and freedom through rehabilitation.

Requirements

Associates Degree or equivalent business classes/medical office experience
Understanding of medical terminology and clinical rehabilitation
Time management skills to handle multiple, competing demands and priorities and work effectively under pressure
Strong, effective organization and interpersonal skills, oral and written
Collaborative team style and open communication, including with other departments
Ability to work independently as well as in a group
Excellent analysis and problem-solving skills
Demonstrated commitment to organizational mission with a “whatever it takes” attitude to get the job done
Credible and trustworthy
Intermediate knowledge of Microsoft Office Suite (Word, Excel, PowerPoint)

Nice To Haves

Three to five years’ hospital medical billing experience
12 to 18 months hospital medical billing experience
In-depth knowledge of payer billing regulations
IRF medical billing experience
Knowledge of ICD-9-CM and CPT coding classification systems

Responsibilities

Prioritize inpatient referrals based on tentative admission dates.
Perform eligibility and benefit verification of identified insurance coverage for each inpatient referral.
Initiate electronic and/or telephone inquiries to the appropriate parties including third party payers, employers, and/or managed care organizations, sharing information as necessary to secure, record, and electronically enter data confirming patient has benefits for inpatient rehabilitation.
Communicate need to pre-certify admission to Utilization Review/Reimbursement Coordinator.
Analyze the available documentation and use software and/or other listings or information, including the data gathered during the third-party eligibility and benefit verification, to calculate the amounts expected to be received from the payer and the amount owed by the patient or his/her responsible party.
Consistently execute time requirements for specific tasks including but not limited to verifications, new patient visit & folder assembly.
Update benefit information on Inpatient Referral Team Site.
Enter insurance information into Access Management Registration.
Meet with each new inpatient after admission to review and verify patient data and insurance information.
Provides information to patients on Patient Rights, Advance Directives, Notice of Privacy Practices, Medicare Patient Appeal Rights, and other required documents.
Accurately generates patient specific Benefit Summary Forms and distributes to patient/representative and appropriate internal parties on a timely basis.
Help insured patient navigate their eligibility and benefits and help un-insured/under insured patient access programs that can assist them by referring them to MFB’s IP Financial Counselor.
Update Access Management Registration with any changes.
Scan signed registration packet documentation into EMR.
Begin CFA review process to preliminarily determine patient eligibility and give an estimate of possible award level.
Act as support staff for the IP Financial Counselor as needed.
Demonstrate excellent customer service and standards of behaviors as well as encourages, coaches, and monitors the same in team members.
Consistently promote teamwork and direct communication with co-workers and deal discretely and sensitively with confidential information.
Contribute by identifying problems and seeking solutions.
Promote patient/family satisfaction where possible; participates in departmental efforts to monitor and report customer service.