Financial Access Specialist

Job Description

Job Description

  Our Mission

All of us, for each of you, every time.

Our Vision

Together, serving as the trusted regional healthcare partner.

Our Values

Listen~Love~Respect~Excel~Innovate

At Samaritan, we do more than deliver healthcare—we make a meaningful difference in the lives of our community every day. We’re committed to creating an exceptional workplace where professionals feel valued, supported, and inspired to provide outstanding care to every patient we serve. The Financial Access Specialist serves the Hospital and Clinic by performing pre-service financial screening and clearance of scheduled patients, including benefit verification and price estimation. This position will maintain a proficient understanding of insurance plans, including State Medicaid, employer-sponsored plans, Medicare Advantage plans and Qualified Health Plans offered via the State Exchange. The Financial Access Specialist will determine benefit coverage levels and connect patients with alternate assistance resources as needed. The Financial Access Specialist interacts in a customer-focused and compassionate manner to ensure patients’ needs are met, and that they understand the hospital and clinic policies for the resolution of patient financial responsibilities and various payment options, including Financial Assistance. In all encounters with patients and families, the Financial Access Specialist will strive for the highest level of customer service.

This is a full-time position working Monday-Friday within the hours of 9:00am-5:30pm PST.

 

ESSENTIAL FUNCTIONS

1. Review schedules for future dates of service on a revolving basis.
2. Answer patient financial inquiries via phone and in-person regarding scheduled and/or future planned visits.
3. Identify patients’ financial needs and align with appropriate resources.
4. Communicate patient financial obligation, provide estimate, and pursue pre-service deposit.
5. Collects from patients who have ability to pay, including past balances, down payments, co-payments and/or deductibles.
6. With the assistance of person(s) responsible for pre-authorization and/or Pre-Registration Specialists, ensures authorization is secure prior to services and maintain accurate record of authorizations.
7. Verify service-specific insurance benefits and provide benefit/coverage review. Accurately explain concepts such as deductible, coinsurance and/or co-payments and how they may affect the cost of care.
8. Explain payment expectations for non-covered and out-of-network services.
9. Review and explain all forms prior to obtaining signatures from patient or appropriate representative.
10. Ensures appropriate forms are signed prior to services (i.e., sterilization permit, No Surprises Act, non-covered waiver, ABN, etc.).
11. Collaborate with Case Management, Billing, Admitting, person(s) responsible for pre-authorization, and pre-registration with the goal of securing payment for services provided.
12. Discuss financial arrangements for newborn(s); informs patients of the timeframe for enrolling a newborn in coverage, provides any documentation or guidance for the patient to enroll their child prior to or after the anticipated delivery date.
13. Keep current with specific insurance rules and changes, including State Exchange.
14. Aid patients in completion of Medicaid application via Washington Healthplan Finder.
15. Promptly notifies insurance company of admissions and discharges per insurance company requirements.
16. Communicate via phone, email, mail, and in-person regarding payment expectations.
17. Comply with HIPAA regulations, maintaining confidentiality and utilizing information only as necessary to complete work.
18. Utilizes appropriate strategies, including phone calls and online databases to verify the insurance coverage of scheduled patients to ensure services are provided and reimbursements are ultimately obtained.
19. Documents all information obtained during patient financial screening to ensure a streamlined process for financial assistance needs.
20. Strong organizational skills, ability to work independently and prioritize tasks.
21. Ensures patient have logistical information necessary to receive their service (e.g., appointment place, date and time, directions to facility).
22. Performs other duties as assigned. Ensures additional accountabilities, as may be required by management, be handled in a manner necessary to meet organizational standards.

 

WORK ENVIRONMENT

The professional in this position reports to the Director of Revenue Cycle. This position works closely with Scheduling (Hospital and Clinic), Financial Counselors, Case Management, Billing, Admitting professionals and Physician offices to ensure completion of all pre-service financial clearance functions.

 

EDUCATION & EXPERIENCE

• Education:

1. 1. Minimum High School Diploma or equivalent required.
   2. Associate’s degree in healthcare administration or equivalent college coursework preferred.

• Experience :
  1. 1-3 years of work experience with insurance verification, revenue cycle functions, hospital/physician offices or related area’s preferred.
  2. 1-3 years customer service experience required.
• Skills/Competencies:
  1. Demonstrates competency on equipment listed on department specific checklist.
  2. Critical thinking skills: Seeks resources for direction when necessary.
  3. Performs independent problem solving. Decision-making is logical and deliberate.
  4. Performs actions that demonstrate accountability. Exercises safe judgement and practices within legal and ethical guidelines.
  5. Demonstrates competency in ability to care for customers/patients across the age continuum.
  6. Demonstrates strong organizational skills.
  7. Provides high quality customer service.
  8. Familiarity with statutes and regulations that can impact financial conversations with patients (e.g., 501(r).

 

PHYSICAL REQUIREMENTS

1. Occasional standing, walking, lifting, reaching, kneeling, bending, stooping, pushing and pulling.
2. Light physical work, but mostly sedentary.
3. Prolonged periods of sitting.
4. Able to list up to 25 pounds.
5. Good reading eyesight.
6. Ability to communicate using verbal and/or written skills for accurate exchange of information with physicians, nurses, health care professionals, patients and/or family, and the public.

 

As a Samaritan professional, you will be asked to commit to being part of a culture grounded in our Mission, Vision, Values, and Strategy that brings service and operational excellence to life each day while creating an exceptional experience for our patients, professionals, physicians, and students. Additionally, how we present ourselves matters, and adherence to our Professional Appearance Policy reflects the pride, respect, and professionalism we bring to those we serve.