Job Description

This position serves as the primary liaison between the health center and patients to ensure care is affordable and compliant with HRSA Health Center Program requirements. This role manages the end-to-end process for the Sliding Fee Discount Program (SFDP), screens for external assistance, manages patient accounts receivable with a strong emphasis on self-pay balances, payment plan creation and oversight, and proactive financial counseling.

Requirements

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. HRSA Sliding Fee Management:

a. Conduct financial screenings to determine eligibility based on income and family size.

b. Processes SFDP applications, renewals, and income verification.

c. Collect and verify required documentation (e.g., pay stubs, tax returns) for Sliding Fee Scale (SFS) applications.

d. Maintain accurate records in the Electronic Health Record (EHR) to ensure audit-readiness for HRSA Site Visits.

e. Monitor and notify patients when their sliding fee eligibility is set to expire.

1. Payment Plan Setup, Monitoring & Compliance:

a. Sets up, monitors, and adjusts patient payment plans for patients with outstanding balances.

b. Conducts follow-up on missed payments.

c. Explains billing statements and patient financial responsibilities in a clear, compassionate manner.

d. Documents all activity in the billing system.

e. Coordinate with the billing department to resolve account discrepancies and process self-pay payments.

1. Patient Accounts Receivable & Self-Pay Balance Management:

a. Proactively manages the self-pay/Patient Accounts Receivable (30, 60, 90+ days) to identify trends and delinquency.

b. Monitors aging, conducts outreach, and reduces outstanding balances.

c. Ensures accounts are reviewed for Sliding Fee eligibility before collections.

d. Account Resolution: Initiate outbound calls and correspondence to patients with past-due balances to secure payment or update financial assistance applications.

e. Payment Plan Auditing: Verify that recurring payment plan installments are processed successfully and troubleshoot failed transactions.

f. Adjustment & Write-off Administration: Prepare accounts for administrative adjustments, small balance write-offs, or referral to external collections in accordance with center policy and HRSA regulations.

g. Reporting: Generate monthly reports on self-pay collection rates, sliding fee utilization, and total outstanding patient debt for management review.

1. Patient Financial Counseling & Affordability Support:

a. Provides compassionate financial counseling.

b. Helps patients apply for Sliding Fee Discount Program.

c. Screen patients for potential eligibility in external programs like Medicaid, CHIP, or the Health Insurance Marketplace.

d. Ensures all financial assistance options are explored.

e. Provide cost estimates for upcoming services and procedures to ensure financial transparency.

1. Statement Processing & Account Maintenance:

a. Reviews and processes patient statements.

b. Ensures accuracy and investigates discrepancies.

1. Collections File Coordination:

a. Prepares monthly collections file.

b. Ensures appropriate internal steps before referral.

1. Administrative & Patient Support:

a. Answers patient billing calls and provides support as needed.

b. Posts payments and prepares reports.

NON-ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Provides backup for other Health Center functions as needed.
2. Performs other clerical and administrative duties and tasks as assigned.

GENERAL EXPECTATIONS:

1. Be committed to the mission of the Bucksport Regional Health Center.
2. Work as a member of the Administrative Office team in the performance of duties.
3. Be punctual with scheduled work and use time appropriately.
4. Work in harmonious relationships with all staff, patients, vendors, and others.
5. Perform duties in a conscientious, cooperative manner.
6. Perform required amount of work in a timely fashion with a minimum of errors.
7. Be neat and maintain a professional appearance.
8. Maintain confidentiality and protect the Center by keeping information concerning operations, patients, and employees confidential.
9. Participation in community activities as a representative of Bucksport Regional Health Center.

PHYSICAL REQUIREMENTS:

The physical requirements described here are representative of those that must be met by the Incumbent to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to stand, walk; sit; use hands to finger, handle, or feel, including operation of a standard computer keyboard; reach with hands and arms and talk, see, and hear. Eye hand coordination and manual dexterity required. The employee must occasionally lift/move up to 25 pounds, bend, stoop, stretch or crouch. Specific vision abilities required by the job include close vision, distance vision, and the ability to adjust focus.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those the incumbent encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work is performed primarily in an office setting. The noise level is usually quiet. Occasional evening or overtime work as needed.

QUALIFICATIONS NEEDED FOR POSITION:

Experience and Skill Requirements: The following experience and skills are considered essential:

• 1-3 years in medical billing, patient accounts, collections, or financial counseling – ideally within a Federally Qualified Health Center (FQHC), preferred
• Proficiency with EMR/Practice Management software
• Strong understanding of Federal Poverty Guidelines (FPG) and HRSA compliance standards.
• Computer experience using Microsoft Windows and Microsoft Office software products, including Word and Excel, required.
• Strong written and verbal communication skills.
• Ability to handle sensitive financial discussions with empathy.
• Exceptional organizational ability and attention to detail.
• Ability to establish and maintain effective working relationships with other employees and the public, using tact and discretion.
• Ability to communicate and present information.
• Ability to identify problems and recommend solutions.
• Ability to establish priorities and coordinate work activities.

Education Requirements: The following education requirements are considered essential:

• High School diploma or equivalent with emphasis on office and business skills including keyboarding, filing, and multi-tasking, required.
• Post secondary education in medical billing/coding or related training preferred.