PFS Patient Svc Specialist II, Financial Clearance

PFS Patient Svc Specialist II, Financial Clearance

40 hours per week, day shift

JOB SUMMARY:  Provides exceptional customer service by performing all registration, HIM, scheduling, reception, and financial functions with accuracy. May float to various operational sites within AHWFB Patient Financial Services (PFS). Expedites and provides healthcare access by obtaining accurate critical data elements from a variety of sources (e.g. patients, families, physicians, etc.).  Ensures reimbursement for services rendered through verification of insurance and benefits and timely authorizations and pre-certs. Identifies, informs, and collects patient's financial obligations. Identifies and refers patients seeking financial assistance to the appropriate internal departments and external agencies.  Fosters positive relationships with all patients and family members, peers as well as external customers to ensure quality services. This position requires multi-tasking and effective problem solving skills. 

EDUCATION/EXPERIENCE:  High school diploma or GED equivalent.  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.  Medical terminology preferred.  Bilingual (Spanish) strongly preferred.

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

ESSENTIAL FUNCTIONS:  
1.    Collects Critical Data Elements, registration information, completes related documents, and prioritizes workload.
2.    Ensures accurate patient identification and addresses sensitive information with confidentiality.
3.    Communicates insurance benefits and liabilities with customers.
4.    Collects past, current and future payments due and advises customers of financial responsibility and resources.
5.    Provides excellent customer service through all interactions and resolves complaints promptly.
6.    Works well independently and as part of a team.
7.    Accesses hospital systems, office technology, payer websites and other resources for assigned responsibilities. 
8.    Adheres to the Medical Center's Values and policies while meeting departmental productivity goals and standards.
9.    Obtains authorizations, pre-certs, documentation when applicable, referrals, reviews and requests medical record information as necessary.
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:

• Excellent oral, written, and interpersonal communication skills
• Problem-solving skills to identify research and assist in resolution of real time issues
• Exceeds PFS goals occasionally and productivity standards based on department requirements
• Works independently with minimal assistance from leadership
• Data entry, keyboarding (WPM 45) and calculator skills
• Strong telephone etiquette
• Organization and time management skills
• Critical thinking and decision making skills
• Ability to perform analysis
• Ability to multi-task
• Identification of system/process improvements
• Basic mathematical skills
• Basic understanding of ICD 9/10 and CPT codes
• Attention to detail
• Ability to receive constructive criticism and take action
• Computer skills to include Microsoft products
• Presents/maintains a professional image

WORK ENVIRONMENT:

• Clinical and office environments
• Occasional long hours, must be flexible and available to provide staffing assistance for any/all disasters or emergencies