Job description
Northern Light Health
Department: Patient Access Management
Position is located: Mercy Fore River
Work Type: Full Time
FTE: 1.0 (40 hours)
Work Schedule: 8:00 AM to 4:30 PM
Summary:
Performs insurance verification duties to financial clear the patient in advance of service date. Verifies healthcare coverage and benefits for applicable services, working with the patient, provider, and payer to ensure accurate information and needs are met in advance of service.
Responsibilities:
• Ensures excellent customer service when assisting patients, providers, and other departments • Collects and updates patient demographic and insurance information, making changes as necessary to ensure accuracy. Handles more complex cases and assists with additional needs pertaining to insurance benefits, referrals or authorizations • Verifies precertification/authorizations for scheduled services utilizing internet sites, payer contacts, and software as appropriate. Assesses coverage and benefits, and accurately determines patient responsibility. • Identifies self pay patients and shares estimate information with financial counseling for assistance with patient financial obligation and options. • Partners closely with the clinical, office, billing, and registration teams and works the authorizations and referrals timely, as applicable • Appropriately documents all conversations with insurance companies and health care facilities that pertain to the payment of services. • Refers patients and/or staff with issues or concerns to supervisor. • Maintains and exhibits a current knowledge of insurance plans, associated workflows and information, and the impact of this role within the revenue cycle. • Strives to maximize revenue and minimize bad debt. • Maintains a safe environment complying with NLH policies and procedures; reports and directly addresses environmental hazards and violations of patient safety policy and/or protocol when involved or observed. • May perform other duties upon request.
Essential:
- Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed.
- Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
- Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.
- Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively.
- Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
- Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
- No previous experience required.
- Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.
- Seeks Process Improvement & Applies System Thinking: Possesses and gains insight into situations, problems and processes. Understands the interconnection between organizational elements. Deconstructs problems and systematically investigates the various components. Considers the impact of actions on the entire process/system. Detects problems and opportunities, recognizes important information, and links various data to trace potential causes and relevant details.
Education:
- High School Diploma/General Educational Development (GED)
Essential:
- Potential exposure to abusive and/or aggressive people.
- Work with computers, typing, reading or writing.
- Lifting, moving and loading 20 to 30 pounds.
- Potential exposure to noise levels being uncomfortable.
- Prolonged periods of sitting.
- Potential exposure to noxious odors.
- Potential exposure to very hot or cold temperatures.
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