Position Purpose: To assist patients with billing and financial programs in a manner complying with federal rules and regulations and demonstrates the Memorial Regional Health’s mission and values.
Essential Functions and Basic Duties:
Position Specific Performance Expectations:
Performs Financial Screening for patient or legal representative in accordance with Financial Policy and established procedural guidelines prior to and during hospitalization and outpatient procedures.
Reviews applications for financial assistance and assist in screening patient for Medicaid and other indigent care programs.
Responsible for the review of all in house patient accounts to determine which accounts are considered in the Financial Risk Category.
Discuss any financial obligation and set up payment plans or payment arrangements with patient prior to discharge / admission.
Assist patients with the navigation of the Colorado Exchange for qualified health plans or coverage.
Assist patient with resolution of issues related to local or state assistance.
Analyze financials and establish payment arrangements on high dollar deductible plans, co-pays and self-pay accounts.
Knowledge of Insurance Contracts.
Verifying that in house patient accounts are in compliance with rules and regulations of their insurance company’s contract.
Works closely with Insurance Verification/Eligibility function and Case Manager/UR/Discharge Planner to ensure smooth financial transition for the patient.
Must meet established productivity and quality guidelines.
Provides estimated quotes for prompt pay discount or time of service discounts.
Posts patient payments of cash and prepares bank deposits.
Posts remittance and payments from Extended Business Offices.
Answer incoming calls from patient, physicians and other sources related to financial questions.
Assist patients with the availability for assistance within the community for programs other than health care coverage.
Correctly and professionally document financials and patient interactions within the CPSI or other systems for financial clearance and counseling.
Handle complaints, provide appropriate solutions and alternatives within the time limits and follow up to ensure resolution.
Relief / Backup for Patient Access duties as needed.
Attends all applicable workshops when possible.
Responsible to monitor Supervisor directed indicators.
Follow communication expectations, guidelines, and policies.
Follow CHOICE Behavioral Standards.
Maintain a knowledge base of programs offered by TMH
Sliding Fee Scale & Charity
Positive and supportive team member to the Patient Access Department that promotes the mission and values of the organization.
Participates in interdepartmental process improvements and process evaluation efforts.
Attends monthly staff meetings.
Acts as an internal consultant and educator to hospital staff in areas of expertise with a caring attitude.
Strives to ensure continual compliance with Departmental and Hospital policies and procedures and State and Federal regulations.
Identifies and accesses system to report abuse of employees and/or patients.
Adheres to policies and procedures for infection control, safety and risk management.
Demonstrates a professional, positive, and caring attitude.
Performs other duties as assigned.
Organization Wide Performance Expectations:
Performs other duties as assigned.
Demonstrates commitment to performing according to the CHOICE values of MRH and representing the organization in a positive and professional manner.
Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff and vendors.
Adheres to MRH and department policies and procedures.
Utilizes initiative; strives to maintain steady level of productivity; self-motivated; manages activity and time.
Completes annual education, training, in-service, and licensure/certification requirements; attends departmental and organizational staff meetings or reads meeting minutes.
Maintains regulatory requirements.
Maintains patient confidentiality at all times.
Reports to work on time and as scheduled; completes work within designated times.
Actively participates in departmental and facility performance improvement and continuous quality improvement activities.
Strives to ensure continual compliance with departmental, hospital, state and federal regulations and policies.
Follows policies and procedures to ensure a safe environment for patients, public and staff.
Must be at least 16 years of age (21 for driving positions)
Must be able to legally work in the United States
Must be able to pass a background check
Must be able to pass a drug screen and breath alcohol test (if applicable)
Must complete employee health meeting
Bachelor’s degree in Business related field or Social Service field, preferred.
Must be able to obtain Colorado Insurance Exchange Navigator certification.
Solid comprehensive knowledge of insurance methodology and financial assistance programs.
Ability to read, understand & reconcile financials.
Medical Terminology preferred.
Two years prior experience as Financial Counselor in the medical field or related experience.
Typing speed of a minimum of 30 WPM
Data Entry Experience
Internal Number: FINAN01193
About Memorial Regional Health
Memorial Regional Health includes a 25-bed hospital, multi-specialty medical clinic and a rehabilitation center, located in, and focused on, caring for Northwest Colorado. Several years ago, the community voted to build a new community hospital and we happily agreed to provide the healthcare services you need most, right here at home. Over the years, we have expanded to include a variety of general care and specialty services. And we’ve only just begun! At MRH, we pride ourselves in taking care of you like family. Many of you know our staff as not only healthcare experts, but friends and neighbors as well. We are dedicated to helping you, personally, reach optimum health, and to increasing the health of our community as a whole. Together, we’re stronger.