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Patient Services Financial Representative

Description

The CSI Companies is a national professional recruiting firm that is currently seeking a Patient Services Financial Representativeto support one of our clients, a highly respected and well-known non-profit healthcare organization in the Orlando/Maitland, FL area.

Shift: M-F 8A - 5P
Salary: $18/hr. 

GENERAL SUMMARY:
The Patient Services Financial Rep, under general supervision, maintains performance standards appropriate to area by obtaining account benefits and/or verifying authorizations are in place for all chemotherapy regimens and treatments, and meeting time line standards established by leadership for all patient services.

S/he meets or exceeds department audit accuracy and productivity standard goal. Uses utmost caution that obtained benefits, authorizations, and/or pre-certifications are accurate according to the actual test, and procedure or registration being performed. 

KNOWLEDGE AND SKILLS REQUIRED:

  • One (1) year experience in Patient Financial Services, Patient Access, Customer Service or related area (registration, finance, collections, customer service, medical office, or contract management)
  • Ability to use discretion when discussing personnel and patient related issues that are confidential in nature
  • Responsive to ever-changing matrix of hospital needs and acts accordingly
  • Self-motivator, and quick thinker
  • Proficient in Microsoft Office Programs such as Outlook, Word, and Excel
  • Proficiency in performance of basic math functions, capability of communicating professionally and effectively in English, both verbally and in writing
  • PREFFERED:
    • Associate’s Degree and/or higher-level education or completed coursework
    • Clinically relevant certification such as Medical Assistant, Patient Care Tech or Pharmacy Tech
    • Two (2) years’ experience in Oncology related business operations within specialty pharmacy, insurance verification, payor reimbursement guidelines, and/or authorization submission.
    • Familiarity with medical terminology and concepts.
    • Working knowledge with third party insurance administrators authorization and clinical care processes.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

  • Responsible for review and coding of chemotherapy regimen/treatment orders. Review of structured clinical data matching against insurance payor and/or National Comprehensive Cancer Network (NCCN) guidelines.
  • Ensuring specified medical terms, diagnosis, medication codes and supporting clinical documentations are met.
  • Utilization review to facilitate the sending of clinical information in support of the authorization to payor or third-party administrators, as assigned.
  • Responsible for communicating to service line partners of situations where medical necessity is not met to include review of journal articles, compendia and/or peer review to justify medical necessity approval.
  • Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information.
  • Accurately enters required authorization information in systems to include length of authorization, total number of visits, and/or units of medication.
  • Responsible for denial notification to clinical counterparts, meeting strict timely notification standards.
  • Completes patient estimates for chemotherapy regimen/treatment plan to include medication units, deductible, coinsurance and out of pocket maximums.
  • Obtains PCP referrals when applicable.
  • Meets or exceeds audit accuracy and productivity standard goals determined by Pre-Access leadership, while meeting timeline standards established by leadership for all patient services.
  • Ensures integrity of patient accounts by working error reports as requested by management and entering appropriate and accurate data.
  • Provides timely and continual coverage of assigned work area in order to offer prompt service to partners.
  • Assists with authorization initiation process if needed.
  • Meets attendance requirements, and maintains schedule flexibility, as required.
  • Exhibits effective time management skills by monitoring time and attendance to limit use of unauthorized overtime.
  • Uses utmost caution that obtained benefits, authorizations, and pre-certifications are accurate according to the actual chemotherapy regimen/treatment and procedures being performed.
  • Ensures all benefits, authorizations, pre-certifications, and financial obligations of patients, are documented on account memos, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts.
  • Conducts diligent follow-up on outpatient and inpatient authorization accounts with third party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed.
  • Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services departments.
  • Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related Pre-Access account issues, within defined time frames.
  • Exhibits effective time management skills and maintains flexibility by being available for all partners and team.
  • May assists team with reports and projects to maintain team and individual productivity standards and goals.
  • Works patient accounts for benefits, monitors accounts for change in chemotherapy regimen/treatment status prior to registration and sends updates to appropriate areas for follow up.
  • Works patient accounts for pre-certification, contacts physician, Patient Access staff, and clinical service area where appropriate.
  • Notifies Patient Access (Financial Advocates) when authorization is not obtained by department deadline, advising of possible denial.
  • Exhibits effective time management skills in completing these tasks.
  • Maintains a current and thorough knowledge of utilizing online and system tools available, working from manual reports during system downtime.
  • Maintains sign-on access to online tools to provide consistent service to patients, clinical partners, and Patient Access team members.
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account.

For additional information, please apply!

 

Requirements

 

Job Snapshot

Location US-FL-Orlando
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Finance
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Company Overview

The CSI Companies

The CSI Companies and its four divisions provide national staffing solutions by placing top talent in the technology, financial, accounting, healthcare, and other professional industries across the country. The CSI Companies are part of Recruit Global Staffing, active in Asia, Europe, North America and Oceania. Recruit Global Staffing is a leading global HR service provider, part of Recruit Holdings Co., Ltd. To learn more about The CSI Companies, visit thecsicompanies.com. Learn More

Contact Information

US-FL-Orlando
Snapshot
The CSI Companies
Company:
US-FL-Orlando
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Finance
Store Type:

Description

The CSI Companies is a national professional recruiting firm that is currently seeking a Patient Services Financial Representativeto support one of our clients, a highly respected and well-known non-profit healthcare organization in the Orlando/Maitland, FL area.

Shift: M-F 8A - 5P
Salary: $18/hr. 

GENERAL SUMMARY:
The Patient Services Financial Rep, under general supervision, maintains performance standards appropriate to area by obtaining account benefits and/or verifying authorizations are in place for all chemotherapy regimens and treatments, and meeting time line standards established by leadership for all patient services.

S/he meets or exceeds department audit accuracy and productivity standard goal. Uses utmost caution that obtained benefits, authorizations, and/or pre-certifications are accurate according to the actual test, and procedure or registration being performed. 

KNOWLEDGE AND SKILLS REQUIRED:

  • One (1) year experience in Patient Financial Services, Patient Access, Customer Service or related area (registration, finance, collections, customer service, medical office, or contract management)
  • Ability to use discretion when discussing personnel and patient related issues that are confidential in nature
  • Responsive to ever-changing matrix of hospital needs and acts accordingly
  • Self-motivator, and quick thinker
  • Proficient in Microsoft Office Programs such as Outlook, Word, and Excel
  • Proficiency in performance of basic math functions, capability of communicating professionally and effectively in English, both verbally and in writing
  • PREFFERED:
    • Associate’s Degree and/or higher-level education or completed coursework
    • Clinically relevant certification such as Medical Assistant, Patient Care Tech or Pharmacy Tech
    • Two (2) years’ experience in Oncology related business operations within specialty pharmacy, insurance verification, payor reimbursement guidelines, and/or authorization submission.
    • Familiarity with medical terminology and concepts.
    • Working knowledge with third party insurance administrators authorization and clinical care processes.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

  • Responsible for review and coding of chemotherapy regimen/treatment orders. Review of structured clinical data matching against insurance payor and/or National Comprehensive Cancer Network (NCCN) guidelines.
  • Ensuring specified medical terms, diagnosis, medication codes and supporting clinical documentations are met.
  • Utilization review to facilitate the sending of clinical information in support of the authorization to payor or third-party administrators, as assigned.
  • Responsible for communicating to service line partners of situations where medical necessity is not met to include review of journal articles, compendia and/or peer review to justify medical necessity approval.
  • Contacts insurance companies by phone, fax, or online portal to obtain insurance benefits, eligibility, and authorization information.
  • Accurately enters required authorization information in systems to include length of authorization, total number of visits, and/or units of medication.
  • Responsible for denial notification to clinical counterparts, meeting strict timely notification standards.
  • Completes patient estimates for chemotherapy regimen/treatment plan to include medication units, deductible, coinsurance and out of pocket maximums.
  • Obtains PCP referrals when applicable.
  • Meets or exceeds audit accuracy and productivity standard goals determined by Pre-Access leadership, while meeting timeline standards established by leadership for all patient services.
  • Ensures integrity of patient accounts by working error reports as requested by management and entering appropriate and accurate data.
  • Provides timely and continual coverage of assigned work area in order to offer prompt service to partners.
  • Assists with authorization initiation process if needed.
  • Meets attendance requirements, and maintains schedule flexibility, as required.
  • Exhibits effective time management skills by monitoring time and attendance to limit use of unauthorized overtime.
  • Uses utmost caution that obtained benefits, authorizations, and pre-certifications are accurate according to the actual chemotherapy regimen/treatment and procedures being performed.
  • Ensures all benefits, authorizations, pre-certifications, and financial obligations of patients, are documented on account memos, clearly, accurately, precise, and detailed to ensure expeditious processing of patient accounts.
  • Conducts diligent follow-up on outpatient and inpatient authorization accounts with third party payers to minimize authorization related denials through phone calls, emails, faxes, and payer websites, updating documentation as needed.
  • Maintains a close working relationship with clinical partners, and ancillary departments to ensure continual open communication between clinical, ancillary, and Patient Access & Patient Financial Services departments.
  • Monitors team mailbox, e-mail inbox, faxes, and phone calls responding to all related Pre-Access account issues, within defined time frames.
  • Exhibits effective time management skills and maintains flexibility by being available for all partners and team.
  • May assists team with reports and projects to maintain team and individual productivity standards and goals.
  • Works patient accounts for benefits, monitors accounts for change in chemotherapy regimen/treatment status prior to registration and sends updates to appropriate areas for follow up.
  • Works patient accounts for pre-certification, contacts physician, Patient Access staff, and clinical service area where appropriate.
  • Notifies Patient Access (Financial Advocates) when authorization is not obtained by department deadline, advising of possible denial.
  • Exhibits effective time management skills in completing these tasks.
  • Maintains a current and thorough knowledge of utilizing online and system tools available, working from manual reports during system downtime.
  • Maintains sign-on access to online tools to provide consistent service to patients, clinical partners, and Patient Access team members.
  • Adheres to HIPAA regulations by verifying pertinent information to determine caller authorization level receiving information on account.

For additional information, please apply!

 

Requirements

 
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