- Obtains daily work through systems’ work queues and reports as assigned by supervisor.
- Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies.
- Contacts patients/families/physicians to obtain additional demographic/insurance information and update in computer system if needed in order to proceed with verification process.
- Demonstrates subject matter expertise with insurance requirements across multiple affiliates.
- Accurately and thoroughly collects, analyzes and records demographic, insurance/financial and clinical data in computer system. Ensures information source is appropriate.
- Explain benefits and request copay, coinsurance and portion of deductible.
- Follows department policy for payment or nonpayment responses.
- Requests patient to bring required documents on day of service, i.e., physician orders, insurance cards, claim forms, liability information, photo ID, etc.
- Documents in system the need for front-end Patient Access Associate to collect at time of service any copay or deductible that could not be collected during the preregistration process.
- Identifies patients in financial hardship and refer to Patient Financial Coordinators for charity/financial assistance.
- Refers to Cash Posting Specialists any patients requiring payment plans.
- Completes registration checklist.
- Documents on accounts using hospital account note with activity comments to ensure easy account follow up.
- Follows EMTALA, HIPAA, payer and other regulations and standards.
- Other duties as assigned
- Adheres to department customer service standards.
- Demonstrate the FOCUS values to provide the best customer services to patients, customers, vendors, and team members.
- Acts willing and ready to assist department personnel with their duties as time permits or need arises.
- Readily identifies work that needs to be performed and completes it without needing to be told
- Requires minimally a High school diploma or GED.
- Two years of experience in a hospital patient access/patient accounts department, medical office/clinic or insurance company is desired/preferred.
- Previous customer service experience.
- Experience interacting with patients and a working knowledge of third party payers and collections is preferred.
- Prior experience with verification, and payer benefit and eligibility systems is preferred.
- Ability to perform a variety of tasks, often changing assignments on short notice.
- Must be adept at multi-tasking
- Will be required to learn and work with multiple software/hardware products (sometimes concurrently) during an average workday
- Must possess excellent communication skills, verbal and listening.
- Must be able to maintain a professional demeanor in stressful situations.
- Adept with technology typically found in a business office environment.
- Mathematical aptitude to make contractual calculations and estimate patient financial obligations.
- Able to build productive relationships with all contacts.
- Must be able to perform data entry with speed and accuracy
- Knowledge of Medical Terminology is preferred.
Company – Unity Point Health