Patient Financial Advisor

About This Role Department Reports to Director of Patient Financial Services Type Requisition # 12658 Position Summary The Patient Financial Advisor (PFA) offers financial advice and assistance to patients regarding medical bills. PSA is the liaison between patients and their insurance companies; often coordinating payments and answering questions from both parties. PFA shall ensure that appropriate reimbursement resources are in place for services provided. If patients are registered without insurance coverages, PFA will actively screen all inpatients and outpatients for other insurance coverages. Other responsibilities are: 1) verification of demographic and insurance information provided, as well as third party insurances; 2) Accurate and timely determination of payer and patient liability, and notifications and initial authorizations required; 3) Validate that required authorizations/notifications are obtained for hospital stay and outpatient services, 4) Adherence to government and non-government program requirements; 5) Effectively communicating with patients as to benefits, program requirements, personal payment liabilities, and options for care and placement that allow for informed decisions by the patient and his/her family while protecting the financial interest of Chinese Hospital Association; 6) Provides information regarding self-pay discounts when no other options are available, sets up payment arrangements as needed; 7) Discusses patient financial liability for services rendered and collects as applicable for those services; 8) Assist eligible patients in the application of Hospital Presumptive Eligibility (HPE), Full Scope Medi-Cal, and referrals to other insurance coverages if not qualifying for Medi-Cal; 9) Apply Treat Authorization Requirement (TAR) for all eligible accounts; 10) Review all assigned DNFB for appropriate billing actions. Essential Duties and Responsibilities Communicate with patients and insurance companies on the phone Appropriately document and report payment information Advises patients and/or family members and Case Management (as applicable) of insurance benefits, exclusions and financial obligations. Determines primary coverage when multiple insurances are involved, collects and verifies insurance eligibility as it applies to services rendered, collects payments, deposits and/or arranges for payment plans if necessary. Educate patients about payment options and financial assistance. Negotiate and strategize patient payment arrangements. Update patient accounts and balances. Review and process patient and insurance company forms. Work with pharmacies and pharmacy insurance programs to make sure prescribed medications are covered by the patient’s financial resources. Provide proper documentation to patient’s insurance company to ensure coverage. Communicate with CHA’s 3 rd party billing to ensure claims are handled efficiently. Ensure all Infusion accounts are pre-admitted, registered and financially cleared. Work with front registration during normal business hours to effectively capture uninsured/underinsured patients for financial assistance. If during off hours, PFA will reach out to the patients the next business day. Follows Hospital and Department policies and procedures at all times, including but not limited to: Administrative Manual, Environment of Care, Human Resources, Infection Control, Corporate Compliance, Code of Ethics, etc. Attend, actively participate and complete in-services, training classes, mandatory classes, seminars/workshops, staff meetings, exercises and drills; reads all department communication and assigned materials. Customer Service – Provides excellent customer service and shows compassion to all patients, visitors and co-workers. Seeks feedback to ensure all needs are met. Anticipates and recognizes the concerns of others, even if those concerns are not openly expressed. Communication – Keeps manager and team informed of progress, problems, development and plans. Gets along and interacts positively with co-workers and others. Accepts and performs other duties as assigned. Qualifications Required Medical Office Experience Computer proficiency (EMR knowledge a plus) Effective communication skills to work with patients, families, doctors and insurance providers Strong Customer Service Ability to effectively present information, both verbal and written. Ability to take initiative, adapt to changing priorities, and work independently Strong time management and prioritization skills Knowledge of Medical Terminology including medications Preferred High School Diploma or GED. Bilingual in Chinese (Cantonese and/or Mandarin) or Spanish Knowledge of community resources and cultural needs. Physical Requirements While performing the duties of this job, staff is regularly required to sit, stand, walk, talk and/or listen. He/she uses his/her hands to do computer work, write reports, do equipment set-up/cleaning/storage, clerical support, etc. He/she will be using the phone frequently. Good vision is needed to be able to read schedules, enter accurate data, etc. He/she must have good general health and demonstrate emotional stability so as to carry out the above-enumerated duties. Able to lift up to 30 pounds Use proper body mechanics when handling equipment Standing, walking and moving 50% of the day Compliance Requirements Complies with Chinese Hospital Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs. Base Pay Scale Starting at $30.98-$34.88 per hour. The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. #J-18808-Ljbffr chinesehospital-sf.org