Job Summary Ensures that an account is established for every scheduled patient. Obtains complete and accurate patient demographics, insurance plan and benefits information, and ensures treatment authorization is secured in advance of the scheduled procedure while maintaining a minimum accuracy rate on reviewed accounts as defined by departmental standards.
Verifies patients' insurance coverage, eligibility, and Point of Service financial obligation for all scheduled services, and documents the system in detail. Adheres to all third party payer requirements for both government and commercial payers. Determines insurance eligibility and coverage, obtains/confirms authorization to avoid non-compliance and penalties to the patient, health system and physician. Communicates current Medicare requirements, HIPAA compliance and reimbursement criteria. Collaborates with Case Management to ensure patient status is correct and documentation is provided to insurances as needed.
Creates and/or updates hospital account. Obtains and enters into hospital information system required patient demographics and insurance information in a timely manner after procedure is scheduled. Documents all information according to departmental guidelines. Provides feedback to supervisor on changes/updates implemented by insurances as obtained.
Contacts patients to verify demographic information and to perform financial counseling prior to time of service. Collects patient responsibility due, provides information on payment plans and financial assistance as necessary. Follows department and network policies concerning discounts, package rates and basic financial assistance.
Internal Number: 2018-11435
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We are a non-profit, local healthcare organization known for community service and outstanding medical quality. Our organization encompasses five acute care hospitals with approximately 10,500 employees and 3,100 volunteers, urgent care centers, clinical research, medical education, an inpatient rehabilitation hospital, an Accountable Care Organization, two foundations, and extensive community services.