Revenue Cycle Support Specialist - FT - Memorial Regional Health : Job Details

Essential Functions and Basic Duties:Position Specific Performance Expectations:

• Provides assistance with special projects within the Revenue Cycle Department.
• Cross-trains with Financial Counselor and all Prior Authorization positions in the department to provide back up when necessary.
• Takes lead on maintaining work queues.
• Provides back up to Financial Counselor position(s) in all areas of the Financial Counselor job description, including but not limited to:
  • May perform Financial Screening for patient or legal representative in accordance with Financial Policy and established procedural guidelines prior to and during hospitalization and outpatient procedures.
  • Reviews applications for financial assistance and assists in screening patients for Medicaid and other indigent care programs.
  • Maintains a knowledge base of programs offered by MRH.
    • Sliding Fee Scale & Charity
    • CICP
    • Medicaid Eligibility
    • HDC
  • Discusses any financial obligation and establishes payment plans with patient prior to discharge/admission.
  • Knowledge of Insurance Contracts.
  • Works closely with Insurance Verification/Eligibility function and Case Manager/UR/Discharge Planner to ensure smooth financial transition for the patient.
  • Assists patient with resolution of issues related to local or state
  • Provides estimated quotes for prompt pay discount or time of service
  • Posts patient payments into cash posting system as well as EMR.
  • Answers incoming calls from patients, physicians, and other sources related to financial questions.
  • Correctly and professionally documents financials and patient interactions within the EMR or other systems for financial clearance and counseling.
• Provides Back up to all Prior Authorization position(s) in all areas of the Prior Authorization job descriptions, including but not limited to:
  • Maintains a clear understanding of all prior authorization processes to provide assistance.
  • Maintains efficient tracking of all pending authorizations to ensure timely resolution.
  • Obtains and verifies patient insurance information is correct.
  • Transcribes incoming orders from external physicians into EMR.
  • Verifies physician orders, authorizations, and demographic information is complete prior to sending to the appropriate hospital scheduling department.
  • Maintains communication with providers, clinical staff, appropriate department staff, and patients in relationship to authorization status.
• Attends all applicable workshops, when possible.
• Follows communication expectations, guidelines, and policies.
• Positive and supportive team member to the Revenue Cycle Department that promotes the mission and values of the organization.
• Participates in interdepartmental process improvements and process evaluation efforts.
• Attends weekly staff meetings.
• Performs other duties as assigned.
• Provides back up to Cash Reconciliation Coordinator including, but not limited to:
  • Post remittance and payments made by patients and insurance companies;
  • Ensure appropriate adjustments are posted to accounts with the proper labeling;
  • Maintaining a high level of data entry
  • Comprehension of payers, EOBs and EFTs;
  • Researches payments received with limited posting information to ensure account accuracy.
• Performs other duties as assigned. Occasional weekend work to support special events.

Organization Wide Performance Expectations:

• Demonstrates 100% commitment to performing according to the CHOICE values of MRH and representing the organization in a positive and professional manner.
• Establishes and maintains effective verbal and written communication and good working relationships with all patients, staff and vendors.
• Adheres to MRH attire/dress code per policies and procedures.
• Utilizes initiative; strives to maintain steady level of productivity; self-motivated; manages activity and time.
• Completes annual education, training, in-service, and licensure/certification requirements; attends departmental and organizational staff meetings or reads meeting minutes.
• Maintains patient confidentiality at all times.
• Reports to work on time as scheduled; completes work within designated timeframes.
• Actively participates in departmental and facility performance improvement and continuous quality improvement activities.
• Strives to uphold regulatory requirements to ensure continual compliance with departmental, hospital, state and federal regulations and policies.
• Follows policies and procedures for infection control, safety, and risk management to ensure a safe environment for patients, public, and staff.

QualificationsMinimum Requirements:

• Must be at least 16 years of age (21 for driving positions).
• Must be able to legally work in the United States.
• Must be able to pass a background check.
• Must be able to pass a drug screen and breath alcohol test (if applicable).
• Must complete employee health meeting.

Required Education/Licensure/Certification:

• High School Diploma or equivalent, preferred.
• Unencumbered License/Certification (if applicable).

Experience:

• Ability to read, understand, and reconcile financials.
• Data entry experience, preferred.
• Medical Terminology, preferred.
• Bilingual, preferred.
• Two (2) years prior experience as Financials Counselor in the medical field or related experience, preferred.
• Prior authorization process experience, preferred.
• Typing speed of a minimum of 30 WPM, preferred.
• Excel Spreadsheets, preferred.

Position Classification: Non-exemptCompensation Range: $19.88 to $27.83Benefits: Medical, Dental, Life, Retirement, Paid Time Off