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Trinity Health - IHA Patient Financial Advocate in Ypsilanti, Michigan

POSITION DESCRIPTION:

Under the direction of the Practice Manager, and in partnership with the Business Services team, this position proactively identifies patient financial need, discusses financial assistance options with patients, assists in obtaining support for patients, and counsels patients on insurance benefits. The incumbent will audit information on the financial application, accurately analyze data and follow up on any discrepancies. Determines eligibility for IHA Patient Financial Assistance and verifies if the patient has additional charity care with which IHA may be able to participate. Once analysis is completed, follow up with patient to discuss their financial responsibility.This position is a shared position with two practices.

ESSENTIAL JOB FUNCTIONS:

  • Ensures that complete and accurate financial information is available and ensures all patients are advised of their financial responsibility. Counsels patient on cost of treatment, insurance benefits, resources for payment, and financial assistance.

  • Responsible for identifying potential payment barriers and alternative payment sources, contracting payment arrangements with patients/families, and resolving patient payment issues. Mails each patient approval/denial letter with explanation.

  • Assists potentially eligible patients in completing forms for bank loans, Medicaid, and other sources of financial assistance within required timeframes.

  • Follows IHA Guidelines for Financial Assistance income eligibility levels grid. Annually updates the eligibility levels grid by locating the US poverty levels for the current year, working with IT and CFO to get approval/update the eligibility level grid, based on the US poverty levels.

  • Determines percentage of charity care. Determines charity care adjustments.

  • Handles incoming calls from patients regarding financial assistance.

  • Keeps up to date on insurance guidelines and changes in charity care programs and has knowledge of collections laws and rules through self- education and seminars as requested.

  • Contacts customers by telephone and letter to arrange payment on delinquent accounts and inquiries regarding assistance needed.

  • Contacts those who have not responded to payment requests. Monitors monthly payers.

  • Prepares reports and maintains account activity logs.

  • Acts as a liaison with other IHA and SJMH service areas, family members, and physicians regarding billing requirements and financial assistance, and coordinates activities to avoid reimbursement delays.

  • Maintains notes on all accounts including, but not limited to, detailed documentation on collection efforts.

  • Reviews, monitors and performs follow-up on patient accounts receivable resulting from assigned reports, tasks and correspondence from practices and patients.

  • Research accounts, verify eligibility, call insurances and send tasks to appropriate Business Services staff or practices to ensure that the patient balance is correct.

  • Informs Business Services Manager and Director of Business Services of any changes, trends or backlogs occurring with assigned accounts.

  • Attends Recharge and Reception Supervisor meetings as necessary, as well as other regularly scheduled meetings, and may be called upon to facilitate meetings and/or take minutes.

  • Provides assistance to team in any area that is needed in order to provide consistent workflow.

  • Trains new and existing staff on IHA policy and procedures that directly relate to the patient financial assistance process.

  • Makes site visits as needed to review the charity care process with providers and/or practice staff.

  • Performs other duties as assigned.

ORGANIZATIONAL EXPECTATIONS:

  • Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the IHA CARES mission and core values statement.

  • Must be able to work effectively as a member of the Business Services team.

  • Successfully completes IHA's "The Customer" training and adheres to IHA's standard of promptly providing a high level of service and respect to internal or external customers.

  • Maintains knowledge of and complies with IHA standards, policies and procedures, including IHA's Employee Handbook.

  • Maintains complete knowledge of office services and in the use of all relevant office equipment, computer, and manual systems.

  • Maintains strict patient and employee confidentiality, including financially-sensitive patient information, in compliance with IHA and HIPAA guidelines

  • Serves as a role model, by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences.

  • Uses resources efficiently.

  • If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

MEASURED BY:

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:

EDUCATION: Associate's degree or equivalent experience required

CREDENTIALS/LICENSURE: None

MINIMUM EXPERIENCE: Minimum 2 years' experience working in a financial services position. Working in a healthcare or non-profit organization strongly preferred.

POSITION REQUIREMENTS (ABILITIES & SKILLS):

  • Knowledge of basic accounting principles and patient billing procedures related to position responsibilities.

  • Strong math skills to include ability to audit financial information.

  • Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, Shore-Tel, NextGen software, Microsoft Word and Excel, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job.

  • Customer service skills to motivate the customer to make payment arrangements that are suitable for both parties.

  • Excellent communication skills in both written and verbal forms with attention to detail, including proper phone etiquette. Communicates professionally with staff and patients to effectively understand and resolve any patient inquiry issues. Ability to speak before groups of people.

  • Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, family members, insurance carriers, charity care program representatives, Social Security office, and vendors.

  • Ability to drive to multiple sites.

  • Ability to approach conflict in a constructive manner. Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.

  • Good organizational and time management skills to effectively juggle multiple priorities and time constraints.

  • Ability to exercise sound judgement, analysis, and problem-solving skills. Help to identify problems, offer solutions and participate in their resolution.

  • Ability to deal with problems involving several concrete variables in standardized situations in order to investigate and resolve patient balance issues.

  • Ability to handle patient and organizational information in a confidential manner.

  • Successful completion of IHA competency-based program within introductory and training period.

  • Sufficient knowledge of medical terminology to perform responsibilities.

MINIMUM PHYSICAL EXPECTATIONS:

  • Physical activity that often requires keyboarding, filing and phone work.

  • Physical activity that often requires extensive time working on a computer.

  • Physical activity that sometimes requires walking, standing, bending, stooping, reaching, and/or twisting.

  • Physical activity that sometimes requires lifting, pushing and/or pulling 20 pounds or less.

  • Specific vision abilities required include close vision, depth perception, peripheral vision and the ability to adjust and focus.

  • Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.

  • Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

MINIMUM ENVIRONMENTAL EXPECTATIONS:

This job operates in a typical office environment which involves frequent interruptions and significant interaction with people which can be stressful at times.

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