Financial Clearance II (Remote)
Company: Trinity Health
Location: Livonia
Posted on: May 6, 2024
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Job Description:
Employment Type:Full timeShift:Description: Hourly Pay Range:
$18.0229 - $27.0010POSITION PURPOSEResponsible for ensuring all
pre-service accounts are financially cleared and secured prior to
the date of service for Trinity Health. Responsible for complex,
high dollar services including surgical, observation and in-house
services. Performs work in the multiple areas of verification:
Outpatient verification, Elective Short Procedure/Inpatient
verification, Urgent Admission verification or Scheduling and is
responsible for obtaining and verifying accurate insurance
information, benefit validation, authorization, and preservice
collections. This is a key position that begins the overall patient
experience and initiates the billing process for any services
provided by the hospital.As a mission-driven innovative health
organization, we will become the national leader in improving the
health of our communities and each person we serve. By
demonstrating reverence, commitment to those who are poor, justice,
stewardship, and integrity, our organization will continue to
provide better health, better care, at lower costs.ESSENTIAL
FUNCTIONSResponsible for financially clearing patients for each
visit type, admit type and area of service via current HIS (Health
Information System). Collects and documents all required
demographic and financial information. Activates registration and
discharges in an appropriate and timely fashion. Coordinates with
Care Management for level of care, Medicare Inpatient Only list,
and required authorizations.Coordinates with OR Scheduling on date
of service changes and/or other revisions or cancellations and
processes accordingly.Analyzes patient insurance(s), identifies the
correct insurance plan, selects appropriately from HIS insurance
and plan selections and documents correct insurance order. Applies
recurring visit processing according to protocol.Verifies patient
information with third party payers. Collects insurance referrals
and documents within HIS. Communicates with patients and
physician/offices regarding authorization/referral requirements.
Identifies potential need for financial responsibility forms or
completed electronic forms with patients as necessary. Escalates
accounts appropriately in accordance with department Defer/Delay
policy to manager.Screens outpatient visits for medical necessity
and issues Advanced Beneficiary Notice as appropriate for Medicare
primary outpatients. Provides cost estimates. Collects and
documents Medicare Secondary Payer Questionnaire (MSPQ) and obtains
information from the patient if third party payers need to be
billed (i.e., worker's compensation, motor vehicle accidents and
any other applicable payer). Maintains operational knowledge of
regulatory requirements and guidelines as outlined in the hospital
and department Compliance Plans. Ensures Meaningful Use
requirements are met as appropriate. Screens all patients self-pay
& out of network patients using approved technology. Provides
information for follow up and referral to the RHM Medicaid Vendor
and/or Financial Counselor as appropriate. Initiates payment plans
and obtains payment. Informs and explains all applicable government
and private funding programs and other cash payment plans or
discounts to the patient and/or family. Incorporates point of
service (POS) collection processes into daily functions.May issue
receipts and complete cash balance sheets in specified areas where
appropriate. Utilizes audits and controls to manage cash accurately
and safely.Maintains and exceeds the department specific individual
productivity standards, collection targets, quality audit scores
for accuracy productivity, collection, and standards for
registrations/insurance verificationCoordinates timely and accurate
appointment scheduling across the region with expertise in
scheduling protocols, insurance requirements and accurate
collection and verification of pre-registration needs on an as
needed basisCommunicates and promptly escalates accounts of concern
to management.Must possess the ability to comply with Trinity
Health policies and procedures. Must be comfortable operating in a
collaborative, shared leadership environmentMaintains a working
knowledge of applicable Federal, State, and local laws and
regulations, Trinity Health s Integrity and Compliance Program and
Code of Conduct, as well as other policies and procedures in order
to ensure adherence in a manner that reflects honest, ethical, and
professional behavior.Other duties as assigned by manager.MINIMUM
QUALIFICATIONSHigh School Diploma or equivalent combination of
education and experience.Must possess a comprehensive knowledge of
financial clearance and insurance verification processes with three
(3) years of financial clearance experience in an acute care
setting.Experienced in processing financial clearance for complex
services including surgical services, observation, and in-house
cases.Strong knowledge in third-party and government payer billing
and reimbursement guidelines as well as department performance
standards and policies and procedures.National certification in
HFMA CRCR and/or NAHAM CHAA within one (1) year of hire.Ability to
communicate and work with patients, physicians, physician office
personnel, associates, multiple direct patient care providers and
others in order to expedite the registration/intake process.
Superior customer service skills and etiquette is strongly
preferred. Must be proficient in the use of Patient
Registration/Patient Accounting systems and related software
systems. Must be proficient in the use of Microsoft Office business
softwareAbility to evaluate and investigate issues to determine
effective resolution to avoid negative financial impact.Must be
comfortable operating in a collaborative, shared leadership
environment. Must possess a personal presence that is characterized
by a sense of honesty, integrity, and caring with the ability to
inspire and motivate others to promote the philosophy, mission,
vision, goals, and values of Trinity Health.PHYSICAL AND MENTAL
REQUIREMENTS AND WORKING CONDITIONSThis position operates remote in
an in-home environment or in an onsite typical office environment.
The area is well lit, temperature controlled and free from hazards.
Incumbent communicates frequently, in person and over the phone,
with people in all locations on product support issues. Manual
dexterity is needed to operate a keyboard. Hearing is needed for
extensive telephone and in person communication. The environment in
which the incumbent will work requires the ability to concentrate,
meet deadlines, work on several projects at the same time and adapt
to interruptions. Must be able to set and organize own work
priorities and adapt to them as they change frequently. Must be
able to work concurrently on a variety of tasks/projects in an
environment that may be stressful with individuals having diverse
personalities and work styles. Ability to thrive in a fast-paced,
multi-customer environment, with conflicting needs which some may
find stressful. May warrant varied and/or extended hours, with
changes in workload and priorities to keep pace with the industry
and advance strategic priorities.Must possess the ability to comply
with Trinity Health policies and procedures.The above statements
are intended to describe the general nature and level of work being
performed by people assigned to this classification. They are not
to be construed as an exhaustive list of duties so assigned.Our
Commitment to Diversity and Inclusion Trinity Health is one of the
largest not-for-profit, Catholic healthcare systems in the nation.
Built on the foundation of our Mission and Core Values, we
integrate diversity, equity, and inclusion in all that we do. Our
colleagues have different lived experiences, customs, abilities,
and talents. Together, we become our best selves. A diverse and
inclusive workforce provides the most accessible and equitable care
for those we serve. Trinity Health is an Equal Opportunity
Employer. All qualified applicants will receive consideration for
employment without regard to race, color, religion, sex, sexual
orientation, gender identity, national origin, disability, status
as a protected veteran, or any other status protected by law.
Associated topics: agent, broker, customer, guest, health,
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Keywords: Trinity Health, Farmington Hills , Financial Clearance II (Remote), Accounting, Auditing , Livonia, Michigan
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