Job Details

POSITION SUMMARY
Responsible for the verification of insurance certification and benefits on patient accounts with a focus on hospital reimbursement. Interpret and ensure compliance with payer guidelines for accurate input. Works in tandem with the financial counselors and personnel from other departments. Handles patient and insurance inquiries. Assist to resolve issues and/or concerns.

POSITION REQUIREMENTS
Minimum Education: High School graduate or equivalent.

Minimum Work Experience: Experience with automated systems. Prior experience involving public contact.

Required Licenses/Certifications: None
Required Skills, Knowledge, and Abilities: Ability to interpret and generate written correspondence utilizing proper grammar, spelling and composition skills. Knowledge of Payer guidelines. Computer knowledge. Ability to operate office equipment, such as copy machines, fax machine and printers. Must be able to work independently with minimal supervision. Good communication skills essential.

Preferred Qualification: One year's experience in a hospital, insurance or office environment. Medical terminology

JOB SPECIFIC FUNCTIONS
1. Demonstrates an understanding of and adherence to the HMHD Compliance Plan.
2. Conduct reflects HMHD's values and a commitment to HMHD's Code of Conduct.
3. Attends the required corporate integrity and compliance training and education programs.
4. Demonstrates proficiency in understanding the materials presented during the corporate integrity and compliance training and education program.
5. Complies with all HIPAA standards.
6. Performs a total assessment of patient accounts to determine verification of insurance and what benefits exist.
7. Enters complete and thorough benefit information to include obtaining required authorizations and patient estimates.
8. Interpret and ensure compliance with payer guidelines for accurate input.
9. Thorough in verifying demographic information and discussing financial obligations when calling patients to start the registration process.
10. Explain pertinent documents and hospital policies.
11. Works in tandem with the financial counselors, personnel from other departments, physician's and their office staff.
12. Handles patient and insurance inquiries. Assist to resolve issues and/or concerns.
13. Attends scheduled departmental meetings.
14. Notifies all insurances in a timely manner to obtain precertification.
15. Screens patient accounts and takes appropriate action when benefits are exhausted or certification is not approved. Immediately refers to the Financial Counselor eligibility vendor.
16. Notifies patient when issues with insurance company exist or, if possible, when there will be an unexpected patient balance.
17. Attempt to pre-register greater than 80% of scheduled patients.
18. Process patient information with a minimal error rate.
19. Resolve issues and/or concerns amicably in a timely manner. Involves PFS Leader when needed.
20. Promote and demonstrate excellent customer service at all times with internal and external customers to include patients, family members, physicians, co-workers and all other customers.
21. Communicates effectively and expresses ideas clearly, actively listens and follows appropriate channels of communication.
22. Adaptable and responsive to change.
23. Uses time clock accurately and is punctual on a consistent basis.
24. Demonstrates a positive attitude in all assigned task and towards others.
25. Follows "Call-In" policy by notifying PFS Leader of absence.
26. Absences during evaluation period: 0-6 Occurrences = Meets Requirements. 7 or more Occurrences = Does not meet requirements.
27. Adheres to hospital and department dress code. Maintains a professional appearance at all times.
28. Consistently contributes to the achievement of excellence in healthcare through the quality and caring values of the mission and vision of Hunt Memorial Hospital District.
29. Perform special duties and projects as assigned.