5:00 PM- 1:30 AM Part Time Includes weekends
Must be fully available 8-5 for orientation
POSITION SUMMARY
The Emergency Financial Representative is responsible for ensuring reimbursement to Client from patients or other responsible parties along with assisting patients in understanding their health care insurance coverage by determining eligibility, benefits and utilization requirements. The Emergency Financial Representative is responsible for up-front POS collections, along with financially securing patients accounts by setting up appropriate financial arrangements with patients to avoid bad debt. The Emergency Financial Representative when appropriate assists patients in accessing programs such as Medi-Cal, Uncompensated Care, and Hospital Presumptive Eligibility. Emergency Financial Representative will focus on individual performance in registration and financial counseling, Key Performance Indicators and expediting approvals by gathering and completing forms before the patient is discharged from the Emergency department. Emergency Financial Representative will continue to enhance their registration and the fundamental financial knowledge and skill set required and expected of this role, which is inclusive of the diverse financial programs offered at Client. The Emergency Financial Representative’s interaction with patients will only transpire after a medical screening exam has been performed. All patients are seen regardless of their insurance coverage or their ability to pay. The Emergency Financial Representative will complete the comprehensive training program and certification as required to facilitate eligibility for Hospital Presumptive Eligibility qualifications when necessary.
SPECIFIC SKILLS NEEDED
• Demonstrates a clear understanding of Client mission and values
• Ability to work directly with the insurance company, healthcare provider, and patients
• Ability to generate revenue with POS collections, establishing payment arrangements, along with collecting on all Self-Pay and/or high liability accounts at the point of registration.
• EMTALA knowledge and experience
• Demonstrates attention to detail and follow up process
• Demonstrates ability to communicate effectively and tactfully with patients, healthcare providers and insurance companies
• Excellent English reading, comprehension and written skills to include spelling skills and penmanship
• Excellent Mathematical skills; ability to calculate copay or percentage of financial estimate amount due and/or establish payment arrangements accurately.
• Ability to follow directions as outlined in policies or given by supervisor
• Strong computer skills to include typing 45+ wpm minimum and in MS office programs
• Excellent organizational skills
• Ability to exercise independent judgment at times of need and emergency situations
• Bilingual preferred
• Interacts with all levels of hospital and outside vendor staff and knowledge of government regulations
• Ability to multi-task in a fast and high pressure environment
• Stringent adherence to all privacy policies and procedures and as required by state and federal law including and not limited to the HIPPA Security and Privacy Rules
• Strong analytical skills, problem solving. The ability to act and decide accordingly.
EDUCATION/EXPERIENCE/TRAINING
Required
• Minimum of two (2) year experience in front office/medical billing and/or current hospital registration/admitting
• Minimum of two (2) year experience in insurance verification and/or medical/hospital billing.
• High school graduate required or equivalent
• Knowledge of eligibility requirements for Medi-Cal, Hospital Presumptive Eligibility Program, Medicare, Covered California, Cobra, limited benefit plans, VVC and Uncompensated Care Programs. IPA knowledge
• Medical terminology
• Non-Violent Crisis Intervention (NCI) Certification within three (3) months of hire date
• LA City Fire Card within 2 week of employment (PIHGS Only)
Preferred:
• Evidence of continuing education in Finance, Accounting or Business Administration
DUTIES AND RESPONSIBILITIES
1. Safeguards and preserves the confidentiality of patient’s protected health information in accordance with State and Federal (HIPAA) regulatory requirements, hospital and departmental policies.
2. Ensures a safe patient environment and adherence to safety practices per policy.
3. With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant other as required.
4. Guest Relations: Exhibits positive guest relations skills by extending oneself and being hospitable to patients, physicians, coworkers, and visitors at all times. Warmly greets these by name and introduces self by name. Uses the phrase, "How can I help you?" as a first line of communication. Anticipates concerns and provides an explanation of the interview process. Utilizes translators if available or new translating system Stratus as necessary to ensure patient fully understands the information being discussed with them. Displays a teamwork approach, considering the impact of his/her decisions, actions and behaviors on others. Works with our eligibility vendor to create a positive working relationship that will provide a smooth process for the patient. Responds to others in a constructive, non-defensive manner. Maintains a professional appearance at all times, wearing uniforms or adhering to department dress code requirement, as per policy. Answers telephone by the third ring and states, “______ department, this is ______, and how can I help you?” Expresses ideas clearly, actively listens and always follows appropriate channels of communication. Maintains confidentiality at all times. Full disclosure is provided to patient when starting the interview and screening process for Hospital Presumptive Eligibility and/or Uncompensated application so they understand the process.
5. Organizational skills and Efficiency: Sets priorities, integrates changes and organizes work activities in a logical and timely manner. When necessary, initiate and complete the application process for HPE or Uncompensated benefits by assisting patients with the completion of all the necessary paperwork. Demonstrates a consistent level of performance and productivity by ensuring all insurance, demographics and eligibility information is obtained and entered into the registration and financial system accurately and notifies appropriate hospital and eligibility staff of changes. Always strives to make good use of time, seeks out work that needs to be done, (ex. works follow up accounts where payment was not secured from previous day, runs assigned reports on a daily bases to ensure financial documentation is entered in a timely manner, etc.,) reports free time to supervisors to provide assistance with other department requirements if needed. Responsible for completing all assigned procedures during shift without sacrificing the quality of work. Responsible for communicating and documenting the financial conversation with patient to support what was financially secured or discussed, along with any financial arrangement made that will affect the account. Contributes valuable insight on improving workflow for department and decreasing patient wait times. Limits personal phone calls to breaks and lunches.
TEAMWORK/CUSTOMER SERVICE RESPONSIBILITIES:
1. Customer Service Values and Behaviors:
1.1 Value: Each person is treated with respect, dignity, fairness and compassion.
Behavior: Performance is acceptable when everyone is promptly greeted with a smile in a warm and
caring manner using the person’s name whenever possible. Now matter how I feel, I
display a caring attitude.
1.2 Value: Each person displays loyalty and pride in Client and upholds the confidentiality of
patients, visitors, physicians, and co-workers.
Behavior: Performance is acceptable when concerns/problems with fellow employees and
customers are not discussed with anyone other than the person involved or the supervisor.
Customer issues and ideas are listened to and appropriate follow up occurs to create a
satisfied customer. I do not make excuses. I do not demean other people or departments.
1.3 Value: Each person demonstrates commitment to open communication.
Behavior: Performance is acceptable when openness and acceptance of constructive criticism
occurs. Positive communication occurs by complimenting and expressing appreciation to
others. I will listen and encourage others to express ideas and opinions.
1.4 Value: Each person demonstrates pride in the physical appearance of all Client properties.
Behavior: Performance is acceptable when the initiative is taken to maintain a clean and safe
environment. I conduct myself in a manner which respects and preserves equipment and the physical plant. I do not walk by spills, trash or unsafe conditions without assuring
that they are attended to promptly by me or appropriate personnel.
PERSONAL QUALITES:
• Punctual
• Effective communication skills, organized, dependable, with a positive professional appearance and attitude
• Must be able to handle multiple tasks at the same time.
• Creative
• Exceptional customer service and negotiation skills
• Organizational skills, analytical skills, time management, ability to work under pressure, decision making and problem solving skills
• High degree of accuracy and attention to detail
• With consideration to age, employee utilizes the approved process to resolve biophysical, psychological, educational and environmental needs to patient/significant others when administering care.
• Ability to plan organize and exercise sound judgment
• Ability to collect, analyze and research complex or diverse information
