Patient Account Rep II - Financial Clearance

Job Detail

Job Title:Patient Account Rep II - Financial Clearance

Req:2024-0313

Location:VMC Main Campus

Department:Financial Advocate

Shift:Days

Type:Full Time

FTE:1

Hours:9 - 5:30

City State:Renton, WA

Salary Range:Min $21.05- Max $35.45/hrly. DOE

Job Description:

This salary range may be inclusive of several career levels at Valley Medical Center and will be narrowed during the interview process based on several factors, including (but not limited to) the candidate's experience, qualifications, location, and internal equity.

JOB DESCRIPTION

The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization.

TITLE: Patient Account Rep II - Financial Clearance

JOB OVERVIEW: This position is responsible for ensuring the timely financial clearance of insured accounts. Position responsibilities include timely and accurate creation of accounts; insurance verification pre-authorization; notification, pre-determination, and financial clearance of accounts prior to service. All functions must be accomplished while operating within the guidelines of federal and state agencies as well as within the confines of contractual agreements with insurance companies.

DEPARTMENT: Patient Financial Services

HOURS OF WORK: Monday - Friday Days

REPORTS TO: Manager, Financial Advocacy

PREREQUISITES:

High school graduate or equivalent (GED) required.

Two (2) or more years of equivalent work experience in a hospital, medical office/clinic, or insurance company.

Demonstrated knowledge of insurance eligibility and financial clearance.

Demonstrated knowledge of medical terminology and abbreviations.

Demonstrated knowledge of Microsoft, Word, Excel, and Outlook.

Demonstrates the ability to communicate effectively in English, including verbally and in writing.Effective communication includes the ability to spell accurately and write legibly.

Prior experience with ePREMIS, and Epic preferred.

QUALIFICATIONS:

Excellent organizational and time management skills.Ability to work effectively in a team environment.

Ability to set priorities, produce accurate work, and process all work tasks in a timely and comprehensive manner.

Comprehensive knowledge of insurance benefits, non-covered services, exclusions, pre-existing conditions, limited benefit plans, and other less-common plans.

Proven experience with online verification websites for eligibility, notifications, benefits, and medical criteria.

Ability to interact professionally and effectively with a wide variety of people, including VMC staff, providers, and patients.

Is neat and well-groomed in appearance.

UNIQUE PHYSICAL/MENTAL DEMANDS, ENVIRONMENT, AND WORKING CONDITIONS: Same as Generic description for Clinical Administrative Partner

PERFORMANCE RESPONSIBILITIES

A. Generic Job Functions: See Generic Job Description for Clinical Administrative Partner

B. Unique Job Functions:

Reviews and edits information in healthcare ADT system, ensuring all fields are populated correctly.

Ensures accounts are registered, verified, and financially cleared per guidelines. Adheres to financial clearance deadlines.

Reviews and prioritizes tasks based on department needs.

Ensures timely notification of hospital admissions regarding payor requirements.

Collaborates with team members and other Revenue Cycle departments as needed to financially clear accounts.

Refers accounts to Financial Advocates where appropriate.

Communicates system and access needs to coordinator and manager in a timely manner to keep the financial clearance process moving.

Maintains current knowledge of insurance plan updates to ensure that bills are compliant with payor requirements.

Maintains confidentiality of all protected health information and patient financial information and views information only when there is a business need.

Follows Patient Identification guidelines.

Maintains thorough documentation of the work done on every account.

Maintains flexibility in job duties to allow for cross training based on department needs.

Adheres to policies and procedures as required by VMC, including the Attendance policy.

Performs other related job duties as assigned.

Created:1/2013

Revised: 8/22, 11/22

FLSA: NE

Grade: OPEIU - K

CC: Varies

Job Qualifications:

PREREQUISITES:

High School Graduate or equivalent (G.E.D)

Two or more years of equivalent work experience in a hospital, medical office/clinic, or insurance company

Demonstrated knowledge of Microsoft Excel, Word, and Outlook, as well as healthcare financial systems. EPIC and ePremis system experience would be preferred.

Evidence of excellent communication skills both oral and written form in the English language including the ability to spell accurately and write legibly.

Demonstrated knowledge of insurance eligibility and financial clearance

Demonstrated knowledge of medical terminology and abbreviations

Excellent customer service skills

QUALIFICATIONS:

Demonstrates excellent team skills

Ability to communicate in writing and verbally in the English language in an effective manner.

Ability to set priorities, produce accurate work and process all work tasks in a timely and comprehensive manner.

Excellent organizational skills, including the ability to function in a setting with a wide variety of duties and numerous interruptions.

Comprehensive knowledge of insurance benefits, non-covered services, exclusions, pre-existing, limited benefit plans, and other less common plans

Proven experience with online verification websites for eligibility, notifications, benefits, and medical criteria

Ability to interact professionally and effectively with a wide variety of people, including operations staff, providers, patients and departments in Valley Medical Center.

Neat, well-groomed, professional appearance.

Requires manual and finger dexterity and vision corrected to normal range.

Salary : $21 - $35