Job Description:

Position Details

Directs SelectHealth members to appropriate providers based upon their medical and mental health needs, plan, and location.
Schedules appointments for members and collaborates with internal teams and external entities to resolve provider gaps to ensure members have access to care at the lowest price.
Mentors colleagues and acts as an expert to resolve escalated issues, specializes in completing follow-up, is competent in multiple products and skills, and provides concierge level services and outcomes.

Minimum Qualificatio ns

• High School Diploma or equivalent
• Current Certified Application Counselor (CAC) and Certified Application Assistant Site (CAAS) certifications
• Minimum of one (1) year of experience in hospital site financial counseling, hospital/medical office, medical insurance and/or customer service
• Demonstrated understanding of state and federal programs available
• Demonstrated knowledge of Medicaid, Medicare, SSDI, and SSI qualification
• Demonstrated knowledge and understanding of the 501r regulation
• Demonstrated knowledge of Connect for Health Colorado programs and the ability to maintain certification
  

Preferred Qualifications

• Previous Certified Application Counselor training (CAC) – State and/or Federal
• At least two (2) years of experience in hospital site financial counseling, hospital/medical office, medical insurance and/or customer service

Scope

As a Patient Finacial Advocate Bilingual you need to know how to:

Register patients. Confirm, enter, and/or update all required demographic data on patient and guarantor on registration system. Avoid overlays and duplicate patient medical records. Follow procedures when identifying a patient and applying the patient identification bracelet. Register patients during downtime following downtime procedures and enter data into registration system immediately upon system availability.

Obtain and explain copies of insurance card(s), forms of ID, and signature(s) on all required forms. Verify information on appropriate accounts to determine insurance coordination of benefits, pre-certification/prior-authorization if not verified by PASC. Complete the Medicare Secondary Payer (MSP) questionnaire when applicable. Verify insurance to determine coordination of benefits and obtain authorization and/or referrals as required. Screen for and process non-covered services and waiver of liability (ABN) through automated screening at time of service.

Inform self-pay patients of liability due, prepayment requirements and coordinate screening of alternate funding sources if applicable. Prepare estimate of procedures, calculate advance payment requirements on previous or bad debt and current balances. Refer potentially eligible patients to financial counseling and/or contract eligibility vendor(s). Coordinate with clinical areas and other ancillary departments to obtain accurate orders in order to establish patient financial expectations.

Collect patient payments and provide accurate receipt. Post all payments in system. Reconcile receipts with cash collected and complete required balancing forms. Document patient account notes for all interactions/transactions.

Maintain departmental and/or individual work queues and reports as required. - Explain/answer patient billing inquiries and interpret statement data to resolve accounts. Escalate account issues which cannot be resolved. Update the emergency department room tracking system, if applicable.<br> Meet departmental productivity and quality standards.

Promote mission, vision, and values of SCL Health, and abide by service behavior standards.

Perform other duties as assigned.

Minimum Qualifications

• High School diploma or equivalent.

Ability to communicate effectively and diplomatically within a multi-functional team.

Strong organizational skills and attention to detail.

Ability to successfully function in a fast paced, service oriented environment.

Physical Requirements:

Manual dexterity, hearing, seeing, speaking.

Location:

Work City:

Work State:

Scheduled Weekly Hours:

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers , and for our Colorado, Montana, and Kansas based caregivers our commitment to diversity, equity, and inclusion .