The Financial Assistance Specialist 2 requires extensive knowledge of Managed Care, Medicaid, Medicaid Disability, Medicare, Healthcare Marketplace Insurance, Hillsborough County Health Care Program (HCHCP), Health Care Responsibility Act (HCRA) and Victims of Crime, as well as having expertise in Customer Service and exceptional time management and organizational skills. The Financial Assistance Specialist 2 works diligently to fund the unfunded/underfunded patients and/or consumers. The Financial Assistance Specialist 2 provides financial clearance to uninsured/underinsured patients scheduled for elective procedures. Will generate and create estimate to provide to patient for self-pay collection. The Financial Assistance Specialist 2 will submit, track and follow Medicaid, HCHCP and HCRA applications to completion, until a denial or an approval is received. Responsible for performing all job duties in accordance with mission, vision and values of Tampa General Hospital.

Essential Functions:

• Interviewing Private Pay and underinsured patients to determine eligibility/affordability for commercial exchange products and for government Financial assistance programs.
• Assessing patient financial capabilities. Enrolling patients/consumers in an exchange plan and acting as a resource to the TGH community for the ACA reform.
• Act as department support for FAS 1.
• Preparation of charity care application, including the Utilization Letter (EA Letter) for illegal aliens as required by the Department of Children & Families (DCF).
• Acquisition of all necessary documentation as required by the respective Government Agencies, including Social Security Disability (SSI/SSD), which may require additional contact with the patient or the patient’s family, even after discharge.
• Submission of the assistance application to appropriate agency within specified timely filing requirements.
• Tracking assistance applications, documenting location, status, approval or denial.
• Attending DCF hearings to appeal cases that have been closed in error or denied.
• Notifying the Financial Assistance Specialist Team Lead of approvals or denials.
• Must provide counseling services for identifying and obtaining payment sources; postponing service for any patient, if no insurance or inappropriate insurance coverage and patient cannot pay the amount due.
• Explain financial accountability to the patient and/or guarantor/family; establish and obtain payment arrangements for patients that cannot be postponed or unable to pay co-pays and/or deductibles at the time of service.
• Notify Medicare patients of the availability and use of Lifetime Reserve Days.
• Notify patients of gaps/weaknesses in coverage and potential non-covered services (i.e. ABN).
• Generates and creates estimates for self-pay patients; provides estimate to self-pay patients and collects payment.
• Follows up on all W/C and Auto admissions missing billing information.

• High School Diploma or GED.
• Must have a minimum of three (3) years Financial Assistance, Patient Access, Patient Accounting or Collections experience.
• Two (2) years' experience in commercial insurance, Financial Assistance applications, Medicaid and/or Medicare applications and Healthcare Marketplace Insurance enrollments.
• An equivalent combination of education and years of experience may be considered.