Pt Financial Access Coordinator

Milford, CT
Aug 14, 2019

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Job Description

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

EEO/AA/Disability/Veteran

Summary:
In the absence and/or with the collaboration of management, the Patient Financial Access Coordinator provides leadership, addresses staffing and coverage concerns and acts as a liaison between staff, management and clinical leadership regarding daily operational issues and changes to process as they arise. In addition, assists patients and families with financial details before, during and after their visit, proactively working with payers, in-house resources and YM//NEMG to identify and resolve issues that hinder optimal patient satisfaction and account resolution. Demonstrates strong problem solving skills in order to navigate patients through the ever changing health care environment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices. Responsible for the coordination of the financial and patient experience aspect from the point of initial contact through account resolution. Is resourceful in obtaining estimates, negotiating settlements and advising clinicians and Department Heads of costs and post-surgical coverage. Works closely with all disciplines in a service line concept, making sound judgments and decisions to support and enhance operations, establish process and resolve barriers and provide continuity of service. Works behind the scenes to help patients and /or families understand and negotiate the access and billing process so patients can focus on their care /treatment. Ensures positive interactions with patients, family members, medical staff, third party representatives and hospital personnel. Promotes good customer service in the work environment. Performs certain statistical and QA functions to develop new procedures and participates in the planning and implementation of system improvements to enhance the operating functions of the department. Responds to and is available to meet with patients/family to explain the financial process in detail and answer any questions or concerns they may have.

Responsibilities:
  • 1. Acts as a Patient Representative: Works as a part of the multi-disciplinary service line team in establishing
    compassionate and tactful relationships with the patient and their family in order to develop an admission and
    financial plan that ensures the needs of the patient, family, physician, and Hospital are adequately met.
    Responds to and is available to meet with patients and/or families to explain the financial process in detail
    and answers any questions that may arise.
  • 1.1. Answers any patient concerns or complaints regarding the access, registration, billing and accounts
    receivable process before, during and after the actual services. Refers any non-financial issues to the
    appropriate designated clinical individual. Follows up on problems to resolve customer dissatisfaction.
    Appropriately initiates and carries through the service recovery process.
  • 1.2. Becomes the point of contact for the patient on all reimbursement matters for both the Hospital and Yale
    Medicine (YM). Follows up to ensure a unified focused approach to patient's financial wellbeing. Serves
    as a liaison to the Hospital, YMG as well as other physician's billing, third party payers and social
    agencies to analyze, identify and resolve patient barriers.
  • 1.3. Screens the patient's financial need for various medical assistance programs, such as Medicaid and
    Free Care, and initiates the application process as dictated by City, State, and Federal regulations.
  • 1.4. Recognizes when errors or potential problems occur (i.e. discrepancies in patient information and
    patient ID issues, etc.) and takes steps to correct.
  • 1.5. Partners with staff to create a patient/family, physician and employee experience that exemplifies
    caring, understanding, efficiency and overall quality of service. Demonstrates the ability to balance
    customer service with the financial needs of the Hospital. Acts as a role model in providing exceptional
    customer service. Follows up on problems to resolve customer dissatisfaction and carries through the
    service recovery process.
  • 1.6. Ability to work throughout Access to ensure patients are processed efficiently and accurately.
  • 1.7. Proactively identifies problems and recommends solutions. Trains fellow employees on correct /new
    procedures and monitors their progress to confirm a thorough understanding of them.
  • 1.8. Strong ability to multitask utilizing multiple computer systems to support efficient decision making and
    patient throughput.
  • 1.9. Assumes responsibilities in collaboration with management and proactively addresses workflow to avoid problems or to meet deadlines.
  • 1.10. All Access involves working 24/7, weekends, holidays, walk-in estimates, benefits, financial counseling.
  • 1.11. Utilizes effective communication skills when coordinating work efforts , training and proposing workflow
    adjustments and processes.
  • 2. Promotes Service Excellence Throughout the Organization: Represents the Access Department in resolving
    issues affecting the daily operations of the area and ensuring a smooth operational work flow between clinical
    and intra/inter departmental areas.
  • 2.1. Participates is work groups to analyze, identify, plan, develop and implement changes to enhance the
    overall performance of the department. Serves as a resource for patients and their family members on
    access to services, insurance and other financial matters.
  • 2.2. Participates in any on-going in-service training to ensure a clear understanding of departmental
    procedures and communicates any changes to staff.
  • 2.3. Attends a minimum of one course a year through the Institute for Excellence to improve growth, educate
    and reinforce staff accountability and overall job performance . Enrolls in the Aspiring Manager course
    offered through the IFE.
  • 2.4. Learns motivational methods and attends training to improve leadership skills (i.e. Departmental Senior
    Workshops, communication skills, advanced Excel) as needed to perform role of Senior.
  • 3. Utilizes a Variety of Software Applications and Reports: Identifies potential patient throughput and account
    receivable trends which hinder effective outcomes. Develops and implements changes as necessary to
    resolve and remove barriers.
  • 3.1. Works independently to analyze the individual patient account and ensures barriers to proper
    reimbursement and patient through put are removed.
  • 3.2. Maintains a strong working knowledge of the Epic system as well as all other systems utilized
    throughout the department.
  • 3.3. Demonstrates proficiency in understanding Epic downtime functions including issuing CSN numbers
    and how to utilize the SRO. Ability to do system recovery including reconciliation.
  • 3.4. Modifies policies and procedures as needed to respond to redesigns in the delivery of healthcare and its
    accompanying reimbursement issues.
  • 3.5. Ensures established procedures are documented, updated and maintained in the appropriate
    Departmental Procedures Manuals.
  • 3.6. Ability to multitask, utilizing multiple computer systems to support efficient patient throughput.
  • 3.7. Identifies and resolves information discrepancies between various software applications.
  • 3.8. Monitors, evaluates, and responds to system abnormalities. Recognizes when to make workflow
    changes (i.e. Epic downtime) and when to escalate issues appropriately.
  • 3.9. Assists and acts as a resource to other team members with troubleshooting on complex problems,
    before bringing it to the attention of the Supervisor.
  • 3.10. Utilizes Excel, Word and PowerPoint to assist in reports, writing documents, training and presentations.
  • 3.11. Maintains a working knowledge of the Kronos system in order to process payroll when assigned by
    management.
  • 4. Problem Solving: Proactively identifies problems and recommends solutions. Trains fellow employees on
    correct/new procedures. Takes necessary steps to address problems or refers issues to the appropriate
    person or department for resolution. Recommends and implements reasonable solutions to address
    problems.
  • 4.1. Works independently and assumes in-charge responsibility and supports the Supervisor in daily
    operations and decisions concerning workflow. Provides feedback regarding employee performance and
    attendance.
  • 4.2. Serves as a resource for other team members when they encounter problems or issues in their
    workflow.
  • 4.3. Identifies and recommends opportunities to improve Patient Access activities.
  • 4.4. Develops potential solutions to be presented to management or work teams. Works in collaboration
    with the clinical staff to identify and resolve complex patient issues .
  • 4.5. Guides others in addressing change and solving problems on a daily basis. Anticipates possible
    problems that may arise when making decisions and acts promptly and carefully in a manner
    appropriate to the situation (i.e. identifies root causes).
  • 4.6. Researches problems and interacts with other departments when necessary to find solutions.
  • 5. Independently works and or coordinates special projects as assigned in the area to address and meet goals
    of the department.
  • 5.1. Participates in ongoing quality improvement efforts of the department , utilizing good problem solving
    methods and resourcefulness to address and resolve problems or to refer them to the appropriate
    person or department for resolution.
  • 5.2. Actively participates in the onboarding of new staff members and is knowledgeable of all aspects of the
    training needs of the employee. Identifies training issues, offers possible solutions and develops training
    procedures and materials, as well as actively participates in the training process.
  • 5.3. Provides timely feedback on staff progress relating to daily operations , letters of commendation and
    performance reviews.
  • 5.4. Provides or arranges coverage as needed throughout Access which in some locations may involve
    working 24/7, weekends, holidays, and storm coverage.
  • 5.5. Must be proficient in handling walk-in estimates, benefits, and financial counseling.
  • 5.6. Actively participates in designated workgroups, in-services and committees.
  • 5.7. Motivates others to seek solutions throughout the work day and facilitates discussions in the work
    group to ensure that tasks are completed.
  • 5.8. Keeps abreast of changing federal, state, and insurance regulations and departmental
    policies/procedures.
  • 5.9. Initiates projects to support the goals of the department.
  • 5.10. Represents the Supervisor at management meetings as required.
  • 5.11. Participates in the mentor program.
  • 5.12. Maintains CHAA or CRCS certification.

    Other information:

    EDUCATION:
    Bachelor's Degree or enrolled in a Bachelor's Degree program. Certified Healthcare Access Associate (CHAA)
    through the National Association of Healthcare Access Management (NAHAM) or Certified Revenue Cycle Specialist
    (CRCS) through AAHAM required within 18 months of hire . Certified as an Epic Super User and proficient in the
    training and use of the Access Epic functions within 2 years of hire.

    EXPERIENCE:
    Four (4) to five (5) years' experience in Access at YNHH or related environment with strong customer service and
    third party insurance background. Must demonstrate exceptional proficiency in all Access locations. Extensive third
    party familiarity and a strong exposure to customer relations and service excellence. Experience in working
    independently to analyze trends, identify obstacles and propose and implement corrective measures.

    LICENSURE:
    Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management
    (NAHAM) or Certified Revenue Cycle Specialist (CRCS) through AAHAM required within 18 months of hire. Certified
    as an Epic Proficiency Super User within 2 years of hire.

    SPECIAL_SKILLS:
    Assumes leadership role with the ability to identify and resolve complex problems independently and make sound
    decisions regarding staffing and work flow assignments. Performs and/or oversees the training, cross-training and
    development of team members with the ability to assess levels of competency and make recommendation as to
    additional training needs. Excellent oral and written communication skills, including presentations. Must have
    excellent analytical skills, demonstrated ability to work independently, analyze trends, identify obstacles and
    propose and implement corrective measures. Must be able to prioritize and re -evaluate continuously based on
    ongoing requests and daily situations. Proficient computer skills and the ability to adapt to various
    programs/systems. Advanced knowledge of Microsoft Office, Word and Excel.


    ACCOUNTABILITY:
    Incumbent is held accountable for coordinating and monitoring the financial activity of complex patient services. Accountable for investigating and researching financial options available to patients to cover the costs of providing comprehensive care and determining patient's financial viability for service. Advises clinicians and patients of their financial clearance status to minimize bad debts and facilitate the collection of the account receivable. Responsible for resolving patient, family and/or clinician concerns as presented and follow through to the point of service recovery. Works in collaboration with management in identifying and addressing trends to improve patient experience.

    COMPLEXITY:
    Demonstrates effective problem solving ability by recognizing when there are potential problems and intervenes to
    make things right. Capable of balancing appropriate level of intervention with staff members, clinical staff and
    patients as needed. Partners with clinical staff to ensure the highest quality of patient care. Handles conflict and
    sensitive situations with discretion and confidence. Modifies operational work flow and procedures as needed .
    Requires dealing with unique situations, exercising discretion and independent judgment in dealing with
    patients/families, care coordinators, physicians, hospital staff and third party insurers. Independently formulates and
    implements solutions to resolve complex problems. Ability to utilize software programs to monitor activity and
    develop statistical reports for purposes of tracking quality assurance and patient throughput.

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    Job Info

    Job: 10790

    Department: Access Operations B
    Category: Finance
    Status: Full Time
    Shift: DAY/EVENING
    Hours: 40.000

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