Patient Financial Specialist II - Maternal Fetal Medicine

About the Position At Mount Carmel, we work to continuously inspire one another. Here, all are welcome. It is this culture of humility and compassion that sets Mount Carmel apart. We see the big picture and do the right thing. That means a dedication to the well‑being of both our colleagues and the patients they serve. Employment Type Full time Shift Day Shift Job Description Excellence in care takes the dedication and commitment of not only our front‑line care teams but of the specialized professionals that support all aspects of our mission. Colleagues in Finance, HR, Marketing and more keep Mount Carmel operating at the highest standard, and we provide leading education, training and development opportunities. The Patient Financial Specialist II performs all the functions of a PFS I and, in addition, verifies prior authorization and obtains precertification for selected scheduled services. This staff member is also proficient in scheduling complex procedures from the physician’s office as well as handling complex and changing insurance/reimbursement requirements. Responsibilities Perform activities related to patient scheduling, pre‑registration, real‑time eligibility verification, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other intra‑departmental functions. Determine proper scheduling requirements and/or limitations according to requested tests/procedures and schedule resources (equipment, staff, room, etc.) in a timely manner to ensure customer satisfaction, maintain patient flow, and appropriate utilization of the service area. Coordinate add‑on and same‑day appointments with the service area, as required, and ensure proper test sequencing with minimal patient delays when multiple testing is required. Provide patient, family and physician office education during the scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions; communicate with various ancillary departments to ensure an accurate schedule and that all reports are properly distributed. Validate medical necessity (LMRP/LCD review) of Medicare and non‑Medicare cases to ensure clinical and financial clearance; contact physicians or office staff for clarification if cases require clarification of diagnosis and/or test(s)/procedure(s). Requirements / Qualifications High School Diploma. At least four years of experience within a physician office, hospital or clinic environment, performing patient scheduling and precertification activities. Proven experience in at least two of the following areas: web and fax orders; outpatient IV scheduling; complex physician office scheduling such as wound care and physician‑performed procedures; or precertification. Excellent interpersonal, attentiveness to detail, and time‑management skills are required. Equal Employment Opportunity Mount Carmel and its affiliates are proud to be equal‑opportunity employers. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. #J-18808-Ljbffr Mount Carmel Health System