Patient Financial Advisor I

Location
Gaithersburg, MD
Posted
Aug 09, 2019
Closes
Aug 27, 2019
Ref
R-6036
Function
Nurse
Industry
Healthcare
Hours
Full Time
GENERAL SUMMARY:
The Patient Financial Advisor is responsible for ownership of patient financial obligations for inpatient, and select outpatient, encounters. They are responsible for ensuring that AHC receives payment for services provided by SGAH, WAH, PHR, and BHW. To this end, they will do any or all of the following:
• Insured patients:
o Confirm coverage requirements for scheduled patients
o Confirm eligibility for insured patients
o Obtain needed authorization for service where applicable for insured patients
o Monitor patient service counts to ensure services are aligned for payments
• Uninsured patients:
o Identify appropriate sources for patients based upon FPL guidelines
o Appropriately assess ability for payment plans or discount plans
o Appropriately refer patients to other payment sources (i.e. Medicaid eligibility vendor)

The Patient Financial Advisor may determine best payment solutions or impact of payment changes at any time during the patient revenue workflow, based on experience and knowledge:
• Pre-service (Scheduling, Pre-registration, etc prior to DOS)
• Point of Service
• Post Service and Pre-claim
• Post Service and Post Claim
• Post Remittance
• Pre-Collection

EDUCATION / TRAINING REQUIREMENTS:
• PFA I:
o Minimum of 2 years experience within a healthcare financial environment. Can include insurer or public health setting as well.
o High School Graduate or equivalent.
• PFA II:
o Minimum of 3 years experience within a healthcare financial environment. Can include insurer or public health setting as well.
o At least 1 years establishing eligibility and/or payment authorizations
o Requires strong knowledge/training in government payor rules and regulations
o Requires strong knowledge/training regarding TPLs, WC, and other payment sources and liabilities
o High School Graduate or equivalent. Some college preferred.
• PFA III:
o Minimum of 5 years experience within a healthcare financial environment. Can include insurer or public health setting as well.
o At least 3 years establishing eligibility and/or payment authorizations
o Requires strong knowledge/training in government payor rules and regulations
o Requires strong knowledge/training regarding TPLs, WC, and other payment sources and liabilities
o Requires knowledge of MD state regulations, 501R, payment, billing, and adjudication processes
o Some college or post HS education required

• Ability to work independently and in a team environment.
• Must maintain a high level confidentiality
• Must work well in stressful environments without compromising quality and accuracy.
• Strong Customer Service skills
• Ability to participate in an environment that promotes staff development, productivity, satisfaction and efficiency
• PC skills in a Windows environment are required. Knowledge and utilization of desktop applications to include Word and Excel is helpful.
• Ability to initiate and follow through on projects and work independently.
• Strong written and verbal communication skills.

WORKING CONDITIONS:
• Frequent pressure due to deadline requirements
• Frequent travel between AHC sites and patients
• Requires judgment that could affect performance and the image of the organization.
• Frequently works at PC involving focused concentration.
• Occasional walking, bending, lifting, stooping, kneeling/crouching, sitting etc.
• Light physical effort (lifts or carries up to 10lbs)
• Atmosphere and environment associated with an office setting
• Must maintain a professional appearance and demeanor at all times

SPECIAL REQUIREMENTS
• This position is within the Revenue Cycle division of AHC and lead/managed by Navigant Cymetrix.
• This position requires incumbents commit to at least one year in role prior to applying for other positions outside of Revenue Cycle

Work Schedule:

Monday thru Friday

Tobacco Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine use.

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine). Those testing positive for cotinine are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing.

Equal Employment Opportunity

Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

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