Primary City/State:Phoenix, Arizona
Department Name:Pre-Heart Trans-Hosp
Job Category:Revenue Cycle
At Banner University Medical Group (BUMG), we're creating a world class medical organization that brings together a leadership team committed to a physician-focused structure, while navigating the challenges of moving from a volume-based to value-based health care system.
As a Patient Financial Specialist on this team, you will provide personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research. You will serve as the patients primary contact liaison for all financial questions related to the their care.
Here is a listing of the BUMG-Phoenix clinics that may be hiring for qualified Patient Financial Specialists:
Advanced Heart Failure Clinic
Ortho/Sports Medicine Institute
Diabetes and Endocrine Clinic
Family Medicine Clinic
Oral Maxillofacial Surgery
Wound Care Clinic
Advanced Liver Disease Clinic
Adult Sickle Cell Clinic
All of these clinics are located within walking distance to the Banner University Medical Center in Phoenix (located near 12th and McDowell).
These are full time, 40 hours/week positions:
Monday-Friday 8A-5P being the most common shift.University Medical Center Phoenix Banner - University Medical Center Phoenix is a nationally recognized academic medical center. The world-class hospital is focused on coordinated clinical care, expanded research activities and nurturing future generations of highly trained medical professionals. Our commitment to nursing excellence has enabled us to achieve Magnet™ recognition by the American Nurses Credentialing Center. The Phoenix campus, long known for excellent patient care, has over 730 licensed beds, a number of unique specialty units and is the new home for medical discoveries, thanks to our collaboration with the University of Arizona College of Medicine - Phoenix. Additionally, the campus responsibilities include fully integrated multi-specialty and sub-specialty clinics, and with a new $400 million campus investment, a new patient tower and 2 new clinic buildings will be built.
This position is responsible for providing personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research. This position partners with the clinical care team to determine financial impact for the patient and serves as the primary contact for any financial questions related to a patient's care across the entire continuum of their treatment, ensuring a seamless experience for the patient and their family.
1. Performs pre-registration/registration processes. Partners with the clinical care team to determine initial authorizations needed based on the predicted care treatment plan. Obtains patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing, if necessary. Assesses need for alternative coverage sources.
2. Verifies insurance coverage and obtains authorizations and notifications throughout the patient's treatment. Obtains all necessary signatures and documentation required by the patient's insurance plan. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, preferred providers and changes in patient's treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patient's care and maximum reimbursement and minimized financial impact to the patient.
3. Provides financial counseling to patients and their families and serves as the primary resource throughout the patient's treatment. Discusses benefits and other financial issues with patients and/or family members during initial referral and during continuation of care. Advises patients on insurance and billing issues and options. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients, families and team members in addressing insurance coverage gaps via alternative funding options.
4. Provides financial advocacy, assistance and support to patients and families, as needed. Assists patients who are un-insured to access other funding resources and completes required documents. Maintains current working knowledge of Medicare, Medicaid and other program benefits and criteria, particularly as they pertain to long-term care and low-income patients. May serve as a liaison between the facility and community in making community resources available to the patient and family.
5. Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence.
6. Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments.
7. May provide leadership and training to other members of the financial team and serves as a resource for internal and external customers.
8. Works independently under general supervision, leads and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient's care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. This position is an integral part of the care team, as they serve as the primary contact for all financial aspects of the patient's care, both for internal and external customers. Internal customers include all levels of the clinical care team, as well as other administrative support positions throughout the facility and organization. External customers include patients and their families, physician office staff and third party payors.
Requires knowledge as typically obtained through an Associate's Degree, with a focus in social work, healthcare administration or finance.
Requires knowledge of medical terminology and an understanding of all common insurance and payor types, authorization requirements and alternative financial resources as typically obtained through a minimum of three years of diversified experience in a hospital Patient Registration/Financial Services setting. Must have highly developed interpersonal, communications and human relations skills. Must also possess accurate and efficient keyboarding skills, strong organizational and time management skills and flexibility in responding to multiple demands. Employees working at Banner MD Anderson or BUMC-P Whole Health Counseling must possess a State of Arizona Department of Public Safety Level One Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment.
Bachelors degree in social work, healthcare administration or finance preferred. Prior experience as a social worker or financial counselor preferred.
Additional related education and/or experience preferred.
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