Job Details

Job Description

Job Description

Primary Function:
•    Understands the importance Einstein Healthcare Network places on providing exemplary customer service and performs job functions in a manner that helps meet the department customer service goals. 
•    Identifies customer service issues and resolves or initiates necessary follow-up. 
•    Efficiently and accurately gathers and inputs patient/guarantor demographic and financial information. Explains necessary forms and obtains signatures from patient/guarantor.  
•    Utilizes appropriate reports to contact insurance payers, verifying benefits and obtaining necessary authorizations. Documents authorization and benefit information in registration system. Work with payors to resolve accounts that are pending or denied. 
•    Screens patient/guarantor for federal, state, county or other assistance programs and completes necessary forms and applications per facility guidelines.
•    Explains insurance benefits and collects current and outstanding co-pays, deductibles and self-pay portions due or establishes payment arrangements for these balances as appropriate.
•    Maintains a working knowledge of third-party reimbursement requirements and regulations.
•    Exhibits working knowledge in the use of all registration and scheduling systems, electronic verification
•    tools and Web based resources.
•    Follows Patient Financial Services self-pay policies including self-pay fee schedules, completion of Medical Assistance and Charity Care Application, explanation of payment options and collections of monies due.
•    Follows Patient Financial Services policies related to cash handling and performs department cashiering functions and point of service transactions.
•    Maintains understanding of the medical necessity screening process and appropriate systems and a working knowledge of ICD-10 and CPT codes.
•    Performs appropriate pre-registration functions including calling physician offices, insurance payers and
•    the patient/guarantor, as necessary.
•    Cross-trained with appropriate knowledge and skills necessary to staff multiple areas within department,
•    including but not limited to Diagnostic/Interventional, Admissions, Cashier, Pre-Registration, Scheduling and Emergency Department.
•    Participates in training of new team members.
•    Work closely with Nursing, Ancillary, Scheduling, Case Management, Social Workers, Managed Care
•    Companies, Physicians, Administration and Patient Accounting.
•    Maintains departmental logs for statistical reporting. Works departmental reports as assigned.
•    Consistently meets Quality Assurance standards set by Patient Financial Services department.
•    Meets departmental goals regarding collections, productivity and customer service.
•    Participates in internal department committees.
•    Assists his/her manager in planning and organizing department activities.

The Financial Counselor/MA Specialist interviews in-house patients referred for Medical Assistance applications. Obtains various paperwork from patients and other hospital departments that are necessary to secure applications according to MA regulations.  Work with County Assistance office and referral agencies to obtain Medical Assistance approvals.  Process and perform system maintenance pertaining to PA 162 forms.  Work with Case Management to insure MA 87s are processed according to MA regulations.  Provide support for MA biller.  

in a manner that demonstrate

Education/Training/Experience:
High School diploma or equivalent 
Two (2) years’ experience in a financial, business office, or customer service environment required. 
One year hospital business office experience required 
Demonstrated computer skills (including Microsoft Word and Excel).        
Working Knowledge of ICD9 coding and medical terminology.  
Able to work with minimal supervision.
Well organized, self motivated individual with a positive attitude. 
Excellent customer service skills. 
Ability to work effectively with all payor and hospital  personnel

Work Shift

Worker Sub Type

Employee Entity

Primary Location Address

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.    

Jefferson is committed to providing equal educa­tional and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. 

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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