Non-Clinical - Administrative - Financial Administrative Representative

ER Financial Representative

The Emergency Financial Representative is responsible for ensuring reimbursement to PIH Health from patients or other responsible parties along with assisting patients in understanding their health care insurance coverage by determining eligibility, benefits and utilization requirements. The Emergency Financial Representative is responsible for up-front POS collections, along with financially securing patients accounts by setting up appropriate financial arrangements with patients to avoid bad debt. The Emergency Financial Representative when appropriate assists patients in accessing programs such as Medi-Cal, Uncompensated Care, and Hospital Presumptive Eligibility.

The Emergency Financial Representative's interaction with patients will only transpire after a medical screening exam has been performed. All patients are seen regardless of their insurance coverage or their ability to pay. The Emergency Financial Representative will complete the comprehensive training program and certification as required to facilitate eligibility for Hospital Presumptive Eligibility qualifications when necessary.

Specific skills needed include a clear understanding of PIH Health mission and values, ability to work directly with the insurance company, healthcare provider, and patients, ability to generate revenue with POS collections, establishing payment arrangements, along with collecting on all Self-Pay and/or high liability accounts at the point of registration. EMTALA knowledge and experience, attention to detail and follow up process, ability to communicate effectively and tactfully with patients, healthcare providers and insurance companies, excellent English reading, comprehension and written skills to include spelling skills and penmanship, excellent mathematical skills; ability to calculate copay or percentage of financial estimate amount due and/or establish payment arrangements accurately. Ability to follow directions as outlined in policies or given by supervisor, strong computer skills to include typing 45+ wpm minimum and in MS office programs, excellent organizational skills, ability to exercise independent judgment at times of need and emergency situations, bilingual preferred, interacts with all levels of hospital and outside vendor staff and knowledge of government regulations, ability to multi-task in a fast and high pressure environment, stringent adherence to all privacy policies and procedures and as required by state and federal law including and not limited to the HIPPA Security and Privacy Rules, strong analytical skills, problem solving.

Education/experience/training required includes minimum of two (2) year experience in front office/medical billing and/or current hospital registration/admitting, minimum of two (2) year experience in insurance verification and/or medical/hospital billing. High school graduate required or equivalent. Knowledge of eligibility requirements for Medi-Cal, Hospital Presumptive Eligibility Program, Medicare, Covered California, Cobra, limited benefit plans, VVC and Uncompensated Care Programs. IPA knowledge. Medical terminology. Non-Violent Crisis Intervention (NCI) Certification within three (3) months of hire date. LA City Fire Card within 2 week of employment (PIHGS Only).

Preferred: Evidence of continuing education in Finance, Accounting or Business Administration.