Patient Access Financial Rep- Referrals and Auths

Roanoke, VA, US, 24015

Employment Status:  Full time
Shift:  Day
Facility:  Park View
Requisition Number:  124276

Job Summary

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.

Mon-Fri, 8:00a-5:00p

Minimum Qualifications

Education: High school graduate or GED required

Experience: 2 years experience in the hospital registration process required. Skilled in registration and billing pathways. Demonstrated knowledge and understanding of insurance practices and requirements. Knowledge of medical terminology. Demonstrated knowledge and understanding of  ICD10 and CPT coding methodology preferred.

Other Minimum Qualifications: Must be able to travel to a variety of locations as needed.  Accurate keyboarding skills, multi-line phone, fax and copier skills required. Excellent organizational skills required. Strong communication skills and customer service orientation. ICD-10 AND CPT coding required during the 1st 6 months of employment. Demonstrated human relations and effective communication skills, excellent organizational skills and multitasking required.

About Carilion

This is Carilion Clinic ...

An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.

Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.


Requisition Number: 124276 
Employment Status: Full time 
Location: Park View 
Shift: Day 
Shift Details: Mon-Fri, 8:00a-5:00p
Recruiter Email:
For more information, contact the HR Service Center at 1-800-599-2537.

Equal Opportunity Employer

Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity

Carilion Clinic is a drug-free workplace.


Carilion Total Rewards

What matters to you is important to us—like benefits, rewards, and resources to improve your life. Carilion understands the importance of prioritizing your well-being to help you develop and thrive. When you make your tomorrow with us, we’ll enhance your potential to realize the best in yourself. Below are benefits available to you when you join Carilion:

  • Employer Funded Pension Plan, vested after five years (Voluntary 403B)
  • Comprehensive Medical, Dental, & Vision Benefits
  • Flexible Work Arrangements/Schedules
  • Remote Work Options
  • Paid Time Off (accrued from day one)
  • Onsite fitness studios and discounts to our Carilion Wellness centers
  • Access to our health and wellness app, Virgin Pulse
  • Discounts on childcare
  • Continued education and training

Find more about Carilion Clinic’s benefits by vising our Total Rewards Page.

Equal Opportunity Employer
Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
Carilion Clinic is a drug-free workplace.

Nearest Major Market: Roanoke

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