Employment Type:

Full time

Shift:

Day Shift

Description:

100% On-site position
Work Hours: 8am-430pm M-F

I             Accountability Objectives:

      Determines liability on patient accounts, and works with patients or their representatives to provide financial

      assistance or secure payment.  Facilitates processing of Medicaid and other financial assistance applications and

      determines eligibility for Mercy Support.

   II            Position Qualifications:

   Minimum Education, Licensure / Certification and Experience Required.

   A.      Education

                  Associate degree in accounting, business management or related field or equivalent work experience required.

   B.      Licensure / Certification

      Not Applicable

   C       Special Skill / Aptitudes

                  Knowledge of accounting principles and patient billing procedures.

                  Knowledge of State, Federal County and Community social welfare programs

                  Interpersonal skills necessary to communicate effectively with patients and families when determining

                  financial status, establishing payment arrangements and collecting accounts, as well as with insurance

                  companies and Patient Accounting department staff.

                  Analytical skills necessary to calculate patient liability, income status and solve problems related to credit

                  and collection matters.

                  Demonstrated knowledge of the SJMO patient accounting systems and accounts receivables.

                  Excellent customer service orientation  skills necessary in order to deal effectively with various levels of

                  hospital personnel, outside customers and community groups.

   D.      Experience

                  Two years related work experience in hospital patient accounts or social service area in order to have

                  knowledge of health insurance benefits, state and county assistance programs and hospital services.

                   Demonstrated effective communications and counseling work experience.

   III          Duties / Responsibilities:

      1          Determines patient's eligility for Mercy Support or other financial assistance based on criteria utilizing

                  patient's financial information provided.

      2          Interviews, assists and provides appropriate information to patients without hospital insurance or limited

                  financial resources with which to pay for hospital services.

      3          Advises patients of hospital charges and requests the patient to provide complete financial information in

                  order to determine need for assistance.

      4          Works the Private Pay Report on a daily basis.  Screens all private pay inpatients for possible insurance and

                  refers those with no insurance to MAS in a timely manner.  Contacts the self pay patient to verify health

                  insurance status and provides financial counseling as necessary, identifying potential sponsorship, secure and

                  document payment arrangements.

      5          Furnishes patient with materials on external and internal programs providing financial assistance.  Makes

                  appropriate referrals and contacts to community agencies for patients needing specialized help or medical

                  supplies.

      6          Provides financial counseling to patients to help alleviate stress precipitated by the need for assistance.

      7          Provides personal assistance with insurance verification, completion of Medicaid forms or the hospital's

                  financial assistance forms.  Assists with additional physician/hospital billing issues.  Retrieves medical

                  records in order to submit to DSS and determine disability eligibility.

      8          Reviews delinquent accounts to ascertain previous collection action taken, status and extent of insurance

                  coverage and potential collectibility.

      9          Process real-time information cards using the MediFax system for Medicaid access.

      10         Ensures appropriate pre-certification number (pacer number) is accurate on the system prior to completing

                  insurance verification on Patient Management.

      11         Process outstanding financial counselor claims daily from the worklist according to the net revenue cycle

                  policies and procedures.  Rebill as necessary.

      12         Acts as liaison with other SJMO service areas, family members and physicians regarding billing

                  requirements and financial assistance.  Coordinates activities to avoid reimbursement delays.

      13         Maintains good rapport and cooperative relationships.  Approaches conflict in a constructive manner.  Helps

                  to identify problems, offer solutions and participates in their resolution.

      14         Maintains confidentiality of information acquired pertaining to patient, physicians, employees and visitors to

                  SJMO.  Discusses patient and hospital information only among appropriate personnel in appropriately

                  private places.

      15         Performs other duties as assigned.

                  Demonstrates and actively promotes an understanding and commitment to the mission of St. Joseph Mercy

                  Oakland through performing behaviors consistent with the Trinity Health Values.

                  Maintains a working knowledge of applicable Federal, State, and Local laws and regulations, the Trinity

                  Health Organizational Integrity Program, including the Standards of Conduct, Code of Ethics, as well as

                  other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and

                  professional behaviors.

                  Supports and conducts one's self in a manner consistent with customer service expectations.

                  In accordance with unit or departmental practice, determines that appropriate charges have been entered for the

                   correct patient, encounter, date/time of service, with any required modifiers.  Make corrections as needed per

                  charge capture policy/practice.

                  In accordance with unit or departmental practice, actively participates in on-going education and

                  communication regarding revenue management.

                  In accordance with unit or departmental practice, assists with tracking and monitoring of equipment assigned

                  to the unit.  Requests services for maintaining equipment as needed.

                  In accordance with unit or departmental practice, proficient with the electronic health records for

                  documentation, assessment, and care management, performing these activities concurrently with provision of

                  care throughout the shift.

   IV          Dept/Unit Specific:

      Not Applicable

   V         Working Conditions:

      •           Normal office environment.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.