Patient Access Financial Rep-Parkview

Responsible for completing verification of insurance benefits for a broad scope of insurance carriers and eligibility for available financial programs, ability to pay and available payment alternatives. Coordinates with physicians, payers and other entities to assure required authorizations are obtained. Audits and corrects data entry discrepancies and reports deficiencies to assure compliance to standard data entry guidelines. Conducts and communicates financial analysis of accounts which may place the system at risk to appropriate parties. Makes financial arrangements for patients without insurance coverage. Research and collect at point of service on bad debt accounts. Collects patient portions and deposits from patients at the point of service.
 

• Completes frequent face to face patient interactions in often challenging clinical environments to gather information and effectively counsel patients on various types of available financial assistance. Conducts interviews and negotiates with patients, relatives, hospital personnel, and other third parties to secure verifications and supporting documentation to be furnished to providers and medical assistance offices in order to enhance opportunities for reimbursement.
• Completes verifications of insurance benefits and eligibility based on established screening criteria. Enters or verifies patient registration demographics and makes corrections, as needed. Documents insurance coverage. Maintains an extensive knowledge of a wide range of insurance plans to accurately determine patient financial liability and payment obligations and to provide knowledge to customers. Completes initiation of inpatient/observation certification based on operational and payer requirements.
• Uses a variety of technology and tools to complete and review assistance applications to assess patient’s eligibility for available financial assistance programs. Coordinates with multiple Carilion disciplines to identify and form action plans for accounts which may place the health system at financial risk.
• Communicates clearly and directly with patient/designee, physician, office staff, various facilities, service lines, and outside agencies in order to accurately determine patient financial responsibility.
• Identifies researches and recommends solutions for problem accounts, processes and subsequent services which may place reimbursement at risk.  
• Responds to customer inquiries and directly participates in account analysis and appropriate investigation while coordinating with the various disciplines to identify scheduled services that may place the health system at financial risk and then completing collaborative process to initiate service deferrals based on Carilion Clinic guidelines.
• Maintains integrity of processes by appropriate use of workflows and system tools using established policy and procedure. Work is subject to audits and review for overall standards of performance.

For more information on Patient Access Services, click HERE:  https://vimeo.com/612623782/ef6bf08f05