Senior Financial Assistance Specialist

Renown Health•Reno, NV

About The Position

The Senior Financial Assistance Specialist performs periodic, random quality reviews of Patient Financial Assistance (PFA) staff applications, insurance verifications, and admission notifications for completeness and accuracy. Reviews include all denied cases to identify missed opportunities caused by delays or inaccurate processing. The specialist reports review findings and trends to the Manager of the Patient Financial Assistance department and other departmental leadership, and helps develop and deliver staff training. This is also a working-lead role that performs regular Financial Assistance Specialist duties, including comprehensive financial screenings and processing applications for federal, state, and county programs, Medical Financial Hardship, insurance verification, and admission notifications. Screenings may take place in person or by telephone and should be completed before admission whenever possible. The specialist identifies potential payer sources, coordinates and submits applications promptly, and works to secure accounts and prevent lost reimbursement. The process should be expeditious, compassionate, and patient friendly. The role requires timely, accurate communication with patients, guardians, family members, physicians, coworkers, government entities, and interdisciplinary partners such as Case Management, Social Services, and Nursing. The position does not provide patient care. The specialist is expected to demonstrate professionalism consistent with Renown Health's Values.

Requirements

At least two years of experience in one or more of the following: commercial medical insurance benefits and eligibility verification; Medicaid screening, applications, and/or eligibility; medical financial counseling; medical claims processing; hospital Business Office follow-up; or professional-office customer-service financial interactions.
Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively.
Ability to perform intermediate math skills.
Understanding of medical terminology.
Ability to obtain and maintain Nevada DWSS Hospital Presumptive Eligibility Certification within 12 months of hire.
Proficiency with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word, and ability to use a computer for online learning, forms, policies, and benefits enrollment.
Annual continuing education requirements apply.
Ability to communicate diplomatically and effectively with patients, guardians, family members, physicians, coworkers, government entities, and interdisciplinary partners.

Nice To Haves

Bachelor's degree preferred.
Bilingual Spanish candidates are given preference.
Experience in an acute care hospital preferred.
Experience with the EPIC system preferred.

Responsibilities

Conduct periodic random quality reviews of PFA applications, insurance verifications, and admission notifications for completeness and accuracy, including all denied cases.
Report quality-review results, application discrepancies, and trends to departmental leadership; provide weekly reports by PFA representative for training purposes.
Conduct comprehensive financial screenings as directed, in person or by telephone, to identify potential federal, state, and county payer sources and pursue appropriate applications.
Facilitate financial-assistance applications before admission when possible, at the bedside, and after discharge through on-site or field visits.
Follow up with patients to obtain supporting documentation for applications.
Maintain documentation of all work activity for each patient account in the appropriate systems.
Communicate and correspond with patients, representatives, designated family members, Renown staff, and government entities regarding accounts.
Complete application summary forms for FAP Committee review and presentation, and monitor cases processed for financial assistance and by the committee through completion.
Complete documentation supporting adjustments for Central Business Office processing and issue decision letters to FAP applicants.
Ensure patient copay balances resulting from FAP approvals are collected.
Identify insurance payer sources and payer-order sequence; verify insurance eligibility and benefits; and provide timely insurance notification.
Determine estimated service costs and identify and collect patient financial obligations, including copayments, coinsurance, and deductibles.
Review delayed or denied applications, verifications, and notifications for appropriate processing and education to help secure accounts and avoid lost reimbursement.
Coordinate with the interdisciplinary team to support a seamless admission and discharge process for referred patients.
Participate in developing and deploying department training modules based on quality-review activities; train staff, answer questions, and monitor workflows regularly.
Participate in the training process and provide reporting to departmental leadership.
Perform Financial Assistance Specialist functions for applications to federal, state, and county programs, Medical Financial Hardship, insurance verification, and admission notification.