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Terry Reilly Health Services Financial Support Specialist in Nampa, Idaho

This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2133293

At Terry Reilly we believe we are successful when we have a healthy, thriving community. This is accomplished as a result of our mission-driven and talented team.

We provide integrated care throughout the Treasure Valley with our medical, dental and behavioral health services - allowing our employees the unique ability to experience several disciplines of health care. It is important to us that our staff is given a healthy work-life balance, so we support and value your time in and out of the office. We also provide our employees with excellent benefits including options for free healthcare.

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*GENERAL RESPONSIBILITIES *

Provide coordination of services to assist patients with high-level financial support to maximize revenue and increase and improve patient communication. Supports patient service by responding to patient inquiries and resolving issues related to their billing.

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ESSENTIAL DUTIES

  • Check eligibility for insured patients prior to visit. Communicate any updates or changes between patient and front office staff to ensure all parties are aware of what to expect at time of visit.
  • Verify benefits for all insured OB patients. Assist and direct self-pay patients on Medicaid enrollment if applicable.
  • Engage with patients to ensure they understand financial responsibility for high-level services such as OB care, Colonoscopies, Endoscopies, Dental surgeries not covered by insurance. Track monitor and manage payments and payment plans.
  • Coordinate with Patient Navigators to assist patients in applying for outside benefits, grants or other funds to enable access to quality care.
  • Manage a quality assurance-auditing plan for patients whom have self-declared their income for our sliding fee program. Report results and/or issues to management staff on a quarterly basis.
  • Mange participation and verification of income for patients elected to receive additional funding from grants or programs such as; Patient Assistance Fund, CHCNI, CDV, CHOIS.
  • Coordinate with patients when it is necessary for them to update their insurance in regards to primary, secondary coverage; PCP identification, or benefit eligibility limitations.
  • Regularly run reports to identify coverage for patients insured by third party insurance not otherwise identified or disclosed in our EHR. Works and maintains retro eligibility process for new Medicaid eligible patients.
  • Reconciles insurance rosters for quality and risk maintenance, including Medicaid, Medicare, Commercial value based contracted insurances.
  • Send statements monthly
  • Processes refunds on overpaid patient balances monthly
  • Receive and post patient payments received via the mail, phone, and online.
  • Updates patient information in practice management system as appropriate to ensure accurate generation of claims and statements.
  • Manages returned mail, including but not limited to; researching for better addresses, suspending statements, handling balances on accounts, and research with statement and collections vendors.
  • Is first on answering phones for the department, handles calls and portal messages within scope of knowledge and transfers all other calls or messages to appropriate person.

MINIMUM QUALIFICATIONS

One to three years of medical office or medical billing experience.

Knowledge of basic billing practices, insurance plans, and collections processes.

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