Job Description

Full time (40 hours weekly)

7:30am-4:00pm

General Summary

Provides financial case management for patients and their families. Evaluates and coordinates a variety of options for managing personal finances to ensure patient's ability to pay for medical services provided. Interviews patients or responsible person/agency to obtain insurance information, arrange methods of payment, recover outstanding balances, and prescreen for ability to pay. Provides counseling to patient and family regarding available financial resources and assistance. Advises applicants for uncompensated care and public assistance on procedures for participation in existing programs. Assists or refers patients to appropriate resources for assistance in completion and submission of applications for public assistance or uncompensated care. Performs a variety of functions including, but not limited to, account follow up, phone queue management, insurance and general billing requirements, registration, answering inquiries, resolving problems, and interacting with the patient, authorized representative, county assistance office, insurance company, attorney, and others to achieve payment or resolution of accounts in accordance with current government and payer regulations. Represents the company in a professional manner using excellent customer service practices, adherence to policies and standards of work in the performance of all duties. This position may offer the option to work from home.

Duties and Responsibilities

Essential Functions:

• Interviews patients or responsible individual(s) to determine present and future financial status and ability to pay medical and/or personal obligations.
• Secures information relative to patient's financial status or insurance coverage. May complete insurance forms, verify insurance coverage, and secure other information as needed.
• Counsels patients requiring external financial assistance, including recommending third parties.
• Refers patients appropriately for completion of applications for medical assistance.
• Interacts with collection agencies. Primary focus is current patient balances.
• Reviews accounts and maintains contact with third parties to ensure timely payments.
• Completes applications for uncompensated care. Notifies patients of uncompensated care determinations.
• Follows policy for outstanding current balance collection efforts and reviews accounts on a scheduled basis.
• Serves as information resource to patients and System staff regarding credit and collection policies, procedures, and payment assistance options.
• Answers inquiries from patients, doctors' offices or third-party payors and follows through to resolution.
• Interprets and explains to patients and their families the charges, services, and policies regarding payment of bills.
• Initiates the process for refund of overpayment to patients, guarantor, or third-party payors after researching to verify credit balance is correct.
• Completes assigned work queues within designated time.
• Performs various functions to complete and expedite the billing process including, but not limited to, escalation to billing leadership, recording patient identification data, investigating charges, correcting data, and preparing the claim to bill
• Resolves billing problems and/or receives insurance updates.
• Posts all payments and adjustments to the correct patient's account.
• Completes patient estimates in the work queue and estimate requests per guidelines.
• Completes review of deceased patient accounts per policy and guidelines.
• Manages department email and voicemail.
• Maintains confidentiality and follows HIPAA compliancy.

Common Expectations:

• Maintains established policies and procedures, objectives, quality assessment and safety standards.
• Participates in educational programs and training.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Qualifications

Minimum Education:

• High School Diploma or GED Required

Work Experience:

• 1 year Customer service, healthcare related field. Preferred

Courses and Training:

• Healthcare terminology. Upon Hire Preferred

Knowledge, Skills, and Abilities:

• Excellent interpersonal/communications skills, insurance knowledge, computer skills, customer service skills, phone etiquette, and multi-tasking.
• Proficiency in Microsoft products and virtual meetings.
• Able to work independently.

Benefits Offered:

• Comprehensive health benefits
• Retirement savings plan
• Paid time off (PTO)
• Education assistance
• Financial education and support, including DailyPay
• Expanded Paid Parental Leave

For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)

WellSpan Health’s vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region’s largest and one of the best in the nation. With a team 23,000 strong, WellSpan experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.