Performs all financial counseling duties including assisting patients with MassHealth applications, review forms, supplements and hardship applications, compiles price estimates for self-pay, insured patients and cosmetic procedures, notifies and collects patient's copays and deductibles due, responds to patient payment and billing inquiries. Utilizes EPIC system, MMIS, Virtual Gateway, Mass Health Portal, INET. Ability to perform back up cashier duties.
Job Specific Responsibilities:
Consistently review and/or contact patients for interview who are identified in Epic as Self Pay, Partial HSN, Non-Contracted Payer, and Welfare Pending accounts, ensuring any insurance coverage is identified, payment is obtained, MassHealth Application is submitted, and/or appointments are cancelled/rescheduled prior to services being rendered or prior to patient being discharged.
Must be comfortable meeting with patients in the Emergency Department setting and on the Inpatient Floors to include ICU and Inpatient Psychiatric Department.
Respond to patient billing inquiries, including accepting payments, assisting with payment plans, working with Customer service department for resolution of billing disputes.
Receive payments for self-pay portion of patient's hospital bill and/or medical services rendered, issues receipt to patient and/or patient's representative and ensures the proper account is credited with payment.
Utilize Epic electronic equipment and tools/scans for Patient Credit Card payments.
May assist in cashiering duties to include, Copay reconciliation, Petty Cash duties, preparing daily deposit from day's receipts, and safekeeping and return of patient valuables held in hospital safe upon presentation of receipt, and finalizing Peoplesoft transactions.
Maintain regular contact with a number of hospital departments on patient billing information such as insurance coverage codes, patient payments or arrangements made, additional charges incurred.
Enters appropriate documentation notes regarding insurance coverage into the Epic Registration System.
Utilize the Mass Health Portal and Virtual Gateway to assist patients with MassHealth applications and ensure that appropriate verification documentation is obtained and submitted timely.
Assist patients in completing MassHealth Review Forms, and various supplemental coverage, including disability and long-term care applications. Obtains and submits appropriate verifications and documentation in a timely manner.
Utilize various online tools for insurance verification, including Nehen, Insurance web sites, and the Virtual Gateway.
Create Patient Estimate Letters for Self-Pay Cosmetic Procedures, collect payment prior to services being rendered, document in Epic payment received, communicate with patient accounts, surgical scheduling, doctors' offices and patients.
Log in to the call center as assigned, answer telephone inquiries in a professional manner, refer proper cases to the appropriate departments, and resolve patients concerns accurately and timely.
Effectively prepare cost estimates (for insured and self-pay patients) for various procedures and testing in a timely manner, provide cost estimates to patients and discuss their out-of-pocket responsibilities and discounts when applicable.
Maintain and stay up to date with State health requirements and changes; complete all yearly financial counseling training timely to ensure compliance and to renew the CAC certification.
Perform a variety of related clerical duties including maintaining records and files, operating standard office equipment such as fax and copy machines.
May perform other related duties as required.
Qualifications
Required: 1+ year related experience and High school diploma or equivalent plus job related training. Good communication skills. Strong interpersonal skills with facility and tact in dealing with others (patients, staff, etc.). Analytical ability and facility with numbers and arithmetic. Accuracy and attention to detail are a strong requirement.
