Patient Resource Specialist
Business Services Department
1.0 FTE, 80 Hours a Pay Period
Days, Hours between 8 am – 4:30 pm
Weekends: No
Holidays: No
Telecommute Available: No
Position Overview:
As the Patient Resource Specialist, you will be responsible for working closely
with our patients and the Winona Health care team to ensure patients are
informed of their insurance coverage or lack of coverage. Duties include
speaking directly with both patients and insurance companies either in-person,
over the phone, or electronically regarding insurance benefits and billing
location (inpatient, outpatient, provider based).
Essential Duties & Responsibilities:
* Gathers and/or verifies patient information including insurance coverage and
confirms patient eligibility.
* Advocates on behalf of patients to ensure maximum benefit available under
patients’ health plan.
* Screens patients for HPE (hospital presumptive eligibility) or connects
patients to appropriate resources for patients to obtain coverage.
* Maintain accurate and detailed records of patient and insurance interactions
which provide clear information on status of patient inquiries/potential
services. Researches account discrepancies in order to explain and educate
patient on account balances.
* Educates, counsels, and helps patients apply for Winona Health Financial
Assistance program either in-person, by phone, or electronically through
secure messaging.
- Will be assigned one or more of the following duties:
- Financial Assistance - Send approvals, denials, and missing information
letters. Apply financial assistance adjustments to accurately reflect
appropriate discount on patient’s account.
* Eligibility and Benefits with Price Estimations – works with pricing
software to inform patient of insurance benefits, insurance coverage, and
price of services. Coordinates with patients to sign any notice of
non-coverage/advance beneficiary notice and collects any balances due at
time of service for any non-covered charges.
* First/Third Party Collections – works with first/third party collection
agencies to review, sign attestations, and complete turnovers. Is the
liaison with the agencies and Winona Health management to coordinate court
dates and settlement offers/agreements.
* Approve Statements – work with statement vendor to ensure daily statement
files are received. Will approve or deny statements based on department
guidelines. Screens and applies uninsured discount per department policy.
* Review and prepare any legal documents for judgements, patient bankruptcy
notices, and worker’s compensation interventions.
* In addition to the responsibilities described above, the role may include
other duties and responsibilities as assigned, based upon Winona Health’s
needs or requirements.
Supervisory Responsibilities:
No direct reports
Skills and Experience:
Required:
- Associates Degree or equivalent experience in a billing related field
- Must become HPE certified within 30 days of hire
- Attention to detail and ability to multi-task
- Advanced time-management and organizational skills to handle multiple
priorities with shifting timeframes
- Basic computer skills: Microsoft Word, Outlook, & Excel
- Discretion and good judgement in responding to questions by patients,
providers, and other professional personnel
* Must possess effective customer service oriented communication skills
Preferred:
- Previous billing and/or collection experience is preferred but not required
- Bilingual in English and Spanish is preferred but not required
Summary of Benefits at Winona Health:
At Winona Health, we are dedicated to offering a comprehensive and affordable
benefits package for our employees and their families. While benefits may vary
based on employment classification and job status, the following key benefits
are available:
Health Insurance: Options for medical, dental, and vision coverage, as well as
mental health support and wellness incentives
Income Protection: Short and long-term disability, plus additional benefits like
accident, critical illness, hospital indemnity, legal assistance, and identity
protection plans
Retirement Planning: Access to a 403(b) retirement plan with employer
contributions once eligibility requirements are met
Work/Life Balance: Flexible scheduling, paid time off, and earned sick time to
support personal well-being
Education & Development: Paid training, tuition reimbursement, scholarships, and
sponsored seminars to foster both personal and professional growth
Employee Discounts: Special offers with local businesses, including the YMCA and
cell phone providers
For more details or specific information, visit our website or contact Human
Resources
Internal Applicant Policy:
It is the policy of Winona Health to work with employees in an equitable fashion
regarding promotions, transfers, and position reclassifications.
Any employee wishing to apply for another available position at Winona Health
must submit an application for consideration through the internal application
portal. Employees requesting to change positions should have successfully
completed at least six (6) months in their current position. Employees currently
in the formal disciplinary process may be required to meet with the Director of
Human Resources to determine eligibility to request transfer. The employee’s
past performance, experience, training and qualifications will be considered in
transfer/hiring decisions. Consideration for transfer or promotion is not a
guarantee of transfer or promotion. Employees may be given a chance to interview
for a position when they meet the minimum position qualifications.
Disclaimer:
Winona Health is an equal opportunity employer. Winona Health does not refuse to
hire, discharge, or discriminate against a person with respect to tenure,
compensation, terms, upgrading, conditions, facilities, or privileges of
employment because of race, color, creed, religion, sex, age, national origin,
marital status, genetic information, status with regard to public assistance,
membership in a local discrimination commission, sexual orientation, disability,
veteran status, or any other prohibited basis of discrimination under applicable
local, state, or federal law. Winona Health does not tolerate retaliation
against any employee, patient/resident, physician, or other individuals pursuing
concerns regarding Civil Rights issues. Winona Health adheres to ALL pertinent
governmental policies and legislation including the Civil Rights Act of 1964,
Title VII, as amended, and the Minnesota Human Rights Act.
