Resource Corporation of America

  • Pre-Service Financial Counselor and Enrollment Specialist

    Posted Date 1 month ago(1 month ago)
    Job ID
    2018-1282
    # of Openings
    1
    Job Location
    US-GA-Savannah
    Category
    Other
  • Overview

    Do you:

     

    •   Understand the power of cause and effect?
    •   Understand with your job that you are a part of something bigger?
    •   Want to come to a place every day where you build relationships that inspire trust and foster cooperation?
    •   Want to work quickly AND efficiently?
    •   Have the inherent ability to recognize the human element of the healthcare profession?

     

    If you answered yes to these questions, then RCA is the place for you!

     

    For over 24 years, RCA's employees have been dedicated advocates for hospitals and the patients they serve.  We are looking to add to our superior team with our opening for a Pre-Service Financial Counselor & Enrollment Specialist. The ideal candidate will provide the highest quality of service to our client partner. The Pre-Service Financial Counselor & Enrollment Specialist assists in completing all necessary functions related to the screening and insurance process for uninsured and under-insured patients who are scheduled at the hospital. This role is accountable for all activities associated with effectively assisting patients prior to a scheduled service that do not have sufficient health insurance coverage to pay for the costs associated with their procedure. 

    Responsibilities

    The Pre-Service Financial Counselor & Enrollment Specialist assists in completing all necessary functions related to the screening and insurance process for uninsured and under-insured patients who are scheduled at the hospital. This role is accountable for all activities associated with effectively assisting patients prior to a scheduled service that do not have sufficient health insurance coverage to pay for the costs associated with their procedure. 

    • Reviews, prioritizes and manages insured work-list within Meditech for both Outpatient Day Surgery and Imaging Departments
    • Contacts patients/guarantors prior to date of service by phone, letter and in person conversation to discuss financial options available
    • Leads the process to determine eligibility and enroll the patient in the identified coverage opportunity on behalf of the patient 
    • Educates and monitors the patient's/guarantor's compliance with the gathering and submission of supporting documentation required for coverage
    • Completes necessary follow up with payers to ensure submitted applications are in process and under active review 
    • Schedules in-person appointments and accepts walk-in patients when necessary to discuss financial options or assist in the enrollment process
    • Travels between facilities as necessary to meet with patients and/or hospital leadership teams
    • Verifies and enters patient's coverage information into hospital system upon receiving approval of eligibility
    • Initiates and secures required prior authorization from the payer for the patient's upcoming service and ensures that authorization number is documented in the appropriate location
    • Requests patients payments prior to service when necessary or required
    • Engages interpreters t speak with patients as necessary
    • Provides updates as required to hospital leadership team and escalates encounters that are at risk of being delayed or cancelled as the result of patient non-compliance
    • Completes continued education requirements to remain up to date with State regulations and processes

    Qualifications

    Required Qualifications: 

     

    • Associate's degree in business administration, economics, finance, healthcare administration or similar
    • Proven experience working with Current Procedural Terminology and medical coding
    • Two years' experience working with Georgia Medicaid programs
    • Strong written and verbal communication skills, including the ability to facilitate in-person interviews with patients effectively and build trust
    • Knowledge of basic medical terminology
    • Mathematical aptitude including the ability to calculate figures and amounts such as discounts and percentages

     

    Desired Qualifications:

     

    • Prior license as a Certified Professional Coder preferred
    • Healthcare and Revenue Cycle experiences preferred
    • Prior experience working with Meditech (Meditech 6.15)
    • Understanding of insurance policies and prior authorization requirements
    • Ability to work in a high activity/fast paced environment
    • Ability to be self-sufficient with tasks and workload and juggle competing priorities
    • Ability to build and maintain effective working relationships with all levels of management and staff
    • Bilingual English and Spanish preferred 

     

    Looking for great benefits?

     

    In addition to competitive salary, RCA offers one of the best benefits packages in the business, including compensated time off, six paid holidays, medical, dental and vision benefits. Also offered is 401K, flexible spending accounts, life insurance and many other supplemental policy options for you to choose from!

     

    RCA employees also enjoy the following perks:

     

    • Teladoc – Free 24/7 access to on-demand doctors for non-emergency consultations for employees and their immediate family members.
    • Verizon Wireless customer? RCA employees are eligible for a 22% discount through Verizon Wireless.
    • Travel discounts through our affiliated partners.
    • Discounted insurance rates through Liberty Mutual
    • Access to discount offers for movie tickets, theme parks, sporting events, shows and much more!

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