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POSITION SUMMARY:
Coordinates all aspects of patient financial account management for high dollar orthotics and prosthetics. Utilizes scheduling and registration information to verify coverage and benefit limitations. May need to contact patients and provider’s offices to gather sufficient information in order to confirm authorization, benefits, price estimation, and collection of patient liability. Works with prior authorization staff to identify lapses and changes in coverage. Works with billing office to monitor denials and write-off activity. Coordinator works independently and solves problems quickly as they arise and will also assist patients with billing related questions. Coordinator is available to patients via Zoom or in-person to answer questions.
This role may have the option to work a hybrid schedule and communicate daily through virtual meetings.
SUPERVISION AND DIRECTION EXERCISED :
Responsible for monitoring own performance on assigned tasks. Self-directed and must make complex decisions independently. May train other support staff.
MACHINES AND EQUIPMENT USED :
Standard office equipment, including but not limited to: telephone, page system, pneumatic tube system, personal computer, printer, photo copier, fax, EPIC, Outlook, scanner and third party verification systems.
ESSENTIAL DUTIES :
Customer Interactions - 25%
Speaks with patients, utilizing professional and excellent communication skills, to deliver a true advocacy experience that focuses on delivering clear and accurate information about patient’s financial obligations and quoted insurance benefits.
Financial Management - 50%:
Reviews Department Appointment Report 7 days prior to patient appointment to verify insurance information.
Consults financial options with patients who have no out-of-network, restrictive or limited coverage and are considering receiving orthotics or prosthetics through URMC. Informs prior authorization staff of patient’s status.
Identifies and confirms self-pay patients for possible Medicaid application.
Notifies and monitors patients COBRA entitlement and assist with paperwork if necessary.
Determines the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits.
Screens accounts to ensure applicable liabilities are identified and billed, updating guarantor and/or coverage, if needed.
Pre-certification/Pre-Determination: Notify Prior Authorization team of any discrepancies, lapses, or changes in coverage to ensure they are able to pre-certify all scheduled services that require an authorization to secure reimbursement.
Work with denial management team to reduce denial rates.
Cross-train within Financial Counseling for coverage purposes.
Accountable for meeting department standards for completion and QA of visits on a day to day bases by utilizing Hold Bill work list.
Quality Management - 25%:
Completes all necessary follow-up on accounts pending information.
Records all actions in EPIC.
Observes visits on the Department Appointment Reports daily for potential cases that are missing registration items or may require new authorizations.
Insurance eligibility tracking.
Identifies areas and recommendations for process/operational improvement.
Attends educational programs for the department at the Manager's direction.
May train or perform other duties assigned by management.
Performs other related duties as assigned.
QUALIFICATIONS :
AAS in related discipline (admitting/registration/patient billing/insurance) with 3 years of related experience, preferably in a hospital setting, or an equivalent combination of education and experience. Medical terminology required. Physician billing experience preferred. Knowledge of coding/medical billing treatment preferred. Must have excellent written and oral communication skills in dealing with patients, physicians and other personnel. Requires a high degree of professionalism and motivation with excellent written and verbal communication and customer service skills; ability to work independently as well as in a team environment; highly collaborative; self-starter; strong computer skills and ability to type 45 words per minute.
NOTE : This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled
Pay Range
Pay Range: $19.37 - $27.12 Hourly
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
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Location: Strong Memorial Hospital
Full/Part Time: Full-Time
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