Major Responsibilities:Oversees daily activities of the Financial Clearance area to ensure department standards are met and department policies and procedures are followed. Identifies staffing needs and communicates those needs to department leadership.Assists development and implementation of policies and procedures to guide and support services, assess and improve work group effectiveness, and ensure patient access competencies are met.Assists in educating staff on any changes pertinent to their roles. Serves as a mentor to financial advocates and other staff members on matters related to financial assistance, patient collections, estimation processes, customer service, payer operations, regulatory concerns, and more.In conjunction with supervisor, develops staff schedules, prioritizes work assignments to ensure optimal use of staff time, monitors staff performance in achieving operating indicators, and oversees work in progress.Responsible for department staff orientation; may develop, plan and/or administer additional staff training opportunities based on department needs. Tailors training accordingly based on whether it is provided in person or virtually.Assists supervisor with human resource responsibilities, including interviewing and selection of new employees, staff development, performance evaluations, resolution of employee concerns, and maintaining employee morale.Supports onsite and remote staff through in-person or virtual monitoring of live and/or recorded calls, with the goal of providing actionable, real-time feedback. Maintains quality assurance statistics and communicates results to department leadership.Problem solves with all parties as necessary to help address insurance coverage gaps via alternative funding options. Provides information to other staff and patients regarding internal and external assistance programs and assists with the application process.Identifies, initiates, and implements improvements to point of service cash collections, price estimation processes, and charity care programs, including pursuing and developing improved techniques and ensuring quality.Functions as a liaison between providers, senior hospital management, and external departments related to revenue cycle, government agencies, charitable organizations and insurance payors. Works cooperatively with other departments, physicians, third-party payers, government officials, patients and their families with an emphasis on identifying any potential patient out-of-pocket expenses. Serves as a point person for resolving patient concerns, questions, or complaints escalated by financial advocates.
Licensure, Registration, and/or Certification Required:None Required.
Education Required:High School Graduate.
Experience Required:Typically requires 5 years of experience in patient financial counseling.
Knowledge, Skills & Abilities Required:Knowledge of guidelines, policies, rules, regulations and laws affecting Medicare, Medicaid, third-party payer requirements, Patient Access and Revenue Cycle processes.Demonstrated ability to successfully supervise financial clearance functions system-wide in conjunction with site leadership. Ability to successfully lead a team.Strong analytical skills including the ability to facilitate data collection, communicate policies and procedures, interpret and relay federal and state regulatory changes.Knowledge of continuous quality improvement and customer focus methods and processes.Excellent interpersonal and oral and written communication skills required in order to communicate effectively with patients, physicians, and other hospital staff members, exercising a high degree of tact and poise.Knowledge of regulations related to patient accounting practices and the self-pay/uninsured.Must be able to work with minimal supervision.Knowledge of and ability to articulate explanations of Medicare/HIPAA/EMTALA rules and regulations and comply with updates on insurance pre-certification requirements.
Physical Requirements and Working Conditions:This position requires travel, therefore, will be exposed to weather and road conditions. Operates all equipment necessary to perform the job.Exposed to a normal office environment.Must be able to sit a majority of the workday.Occasionally lift up to 10 lbs.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.