PFS Patient Svc Specialist I, Financial Clearance

PFS Patient Svc Specialist I, Financial Clearance

40 hours per week, day shift

JOB SUMMARY:  Provides exceptional customer service by completing patient registration duties.  Responsible for collecting and validating accurate patient insurance information, obtaining pre-certification or authorization, and entering all necessary information into Atrium Health Wake Forest Baptist (AHWFB) registration system. Informs patient of estimated liability, collects patient liabilities, identifies and refers patients in need of financial assistance to financial counseling as necessary.  Fosters positive relationships with peers, patients, family members, and external customers to ensure quality services.

EDUCATION/EXPERIENCE:  High School diploma or GED equivalent.  Work experience in a healthcare setting (receptionist, registration, financial assistance, etc.) preferred.  Working knowledge of applicable rules, regulations and guidelines governing insurance payers and reimbursement preferred.  Bilingual (Spanish) strongly preferred.  Computer skills to include word processing required.

LICENSURE, CERTIFICATION, and/or REGISTRATION:  N/A

ESSENTIAL FUNCTIONS:
1.  Collects patient critical data elements, registration information, and completes documents, prioritizing  
    workload.
2.  Ensures accurate patient identification and addresses sensitive information with confidentiality.
3.  Obtains authorizations, pre-certs, documentation when applicable, referrals, reviews and requests 
    medical record information as necessary.
4.  Communicates insurance benefits and liabilities with customers.
5.  Collects past, current and future payments due and advises customers of financial responsibility and 
     resources.
6.  Provides excellent customer service through all interactions and resolves complaints promptly.
7.  Works well independently and as part of a team.
8.  Accesses hospital systems, office technology, payer websites and other resources for assigned 
    responsibilities. 
9.  Adheres to the Medical Center's Values and policies while meeting departmental productivity goals 
    and standards.
10.Communicates effectively with various internal and external healthcare team members.
11.Attends required training classes, seminars and meetings.
12.Performs additional tasks and responsibilities as requested by department management.

SKILLS/QUALIFICATIONS:

• Evidence of good interpersonal skills with customer service focus
• Effective communication skills (oral and written) and creative problem solving
• Ability to work with Web-based programs to review insurance eligibility and benefits
• Ability to multi-task
• Strong math and analytical skills
• Attention to detail

WORK ENVIRONMENT:

• Clinical and office environment
• Regular exposure to the risk of blood-borne diseases, infectious, and contagious diseases
• Contact with patients, family members, visitors, co-workers, and medical staff under a wide variety of circumstances.
• Subject to multiple interruptions
• Requires working under stressful conditions with providers and patients
• Handles complaints, settles disputes, and resolves grievances and conflicts
• Occasionally works irregular hours