Why You’ll Love This Job
This position leads a team, or teams, within the Revenue Cycle organization that coordinates and facilitates financial clearing patients prior to surgery including building estimates, taking patient phone calls, following up on authorizations and collecting funds prior to service.
Job Duties and Responsibilities
- Confirm valid coverage for services and location by contacting insurance companies and/or review electronic responses for benefit information.
- Manage patient insurance demographic information to verify authorization obligations.
- Verify that service is a covered benefit, based on knowledge of the specific insurance plan, the specific benefit package restrictions, and the timing of the service.
- Understand patient deductibles, out-of-network referrals and out-of-pocket limitations.
- Review the account and timing of last patient demographic query to identify missing standard and/or required information. If necessary, contact the patient to complete the information.
- Calculate and collect patient liability before or at the time of service. Communicate the liability and explain the calculation low and high amounts when necessary.
- Identify the potential need for assistance when the coverage/benefit is either inadequate or nonexistent for a medically necessary service, and if necessary, create a payment plan with the patient and document the agreement appropriately.
- Oversee and lead the assigned team to deliver on their goals and work to remove barriers to the team’s success.
- Reviews and approves employee time at and away from work to ensure proper coverage.
- Works with Revenue Cycle leadership to determine the appropriate team goals to meet the business needs and directs the execution of the billing workflow to hit the agreed upon targets.
- Provides training and skill assessment for billing team members including the development and delivery of a periodic Quality Assurance plan.
- Assists team members with their professional development in support of Atlas business goals
- Develops the appropriate training and onboarding of new employees
- Participates in the recruiting and assessing candidates for the Financial Clearance team as opportunities arise.
- Provide guidance and support to all Atlas parties to improve overall performance including the financial clearance days out, point of service collections and clean claim rate.
- Exhibits an interest in technology, automation and data driven solutions to the team’s business challenges.
- May work payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment to help the team meet goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing.
- Builds strong working relationships with assigned business units, departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients.
- Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors and Revenue Cycle stakeholders accurately.
- Work experience with HST Pathways, Mnet, and Waystar systems is preferred.
- Additional related education and/or experience preferred.
- Professional Certification through HFMA or AAHAM preferred
- Focus on creating and maintaining procedures that align with a high standard of compliance and internal control
- Working knowledge of patient accounting and experience reconciling AR accounts
- Excellent communication skills, written and verbal
Type: Full Time (Salaried)
Job ID: 112636