**Primary City/State:**
Tucson, Arizona
**Department Name:**
Pre-Lung Trans-Hosp
**Work Shift:**
Day
**Job Category:**
Revenue Cycle
Health care is constantly changing, and at Banner Health, we are at the front of that change. We are leading health care to make the experience the best it can be. We want to change the lives of those in our care – and the people who choose to take on this challenge. If changing health care for the better sounds like something you want to be part of, we want to hear from you.
Banner University Medical Center Transplant Institute is Arizona’s most experienced transplant center, providing comprehensive care to adult patients in pre- and post-transplant acute clinics for heart, lung, liver, and kidney/pancreas transplant, as well as long term follow up on the transplant recipient. As part of the Banner Health Academic Medical Division, we offer Transplant Services in Phoenix and Tucson, AZ. Our Transplant Institute prides itself on delivering compassionate, quality care to our patients and families leading to successful, optimal outcomes. Performing over 450 transplants per year, our programs are poised for continued growth!
As a **Patient Financial Services Representative** with **Banner University Transplant Institute in Tucson,** you will be responsible for running insurance eligibility and benefits to determine amounts due, collecting payments, scheduling appointments, as well as other administrative duties as needed.
Your position will be remote hybrid with **residency in Tucson, Arizona is required.** Some in clinic time will be needed. Your shifts will be Monday-Friday business hours that follow the operating hours of the clinic. If this role sounds like the one for you, apply today!
Banner - University Medical Center Tucson is nationally recognized for providing exceptional patient care, teaching future health-care professionals and conducting groundbreaking research. Also located on the campus is Diamond Children's - recognized for its specialized pediatric services including neonatal and intensive care, emergency medicine and cancer therapies. Banner - University Medical Center Tucson is a Level 1 Trauma Center, meaning we care for the most critically injured patients. The hospital is consistently listed among the nation's top hospitals in the prestigious Best Hospitals ranking by U.S. News & World Report. The academic medical center has earned Magnet Recognition becoming the only hospital in southern Arizona to meet the rigorous standards of the American Nurses Credentialing Center’s Magnet Recognition Program® for nursing excellence. The hospital's physicians are full-time faculty of the University of Arizona College of Medicine - Tucson. Our specialty services include comprehensive heart and cancer care, advanced neuroscience techniques and a multi-organ transplant program.
POSITION SUMMARY
This position is responsible for providing personalized coordination, clarification and communication of all financial aspects of care continuum, including insurance and authorization verification, registration, financial counseling and claims research. This position partners with the clinical care team to determine financial impact for the patient and serves as the primary contact for any financial questions related to a patient’s care across the entire continuum of their treatment, ensuring a seamless experience for the patient and their family.
CORE FUNCTIONS
1. Performs pre-registration/registration processes. Partners with the clinical care team to determine initial authorizations needed based on the predicted care treatment plan. Obtains patient insurance benefit information for all aspects of the treatment, including, but not limited to, inpatient and outpatient services, prescription drugs, and travel and housing, if necessary. Assesses need for alternative coverage sources.
2. Verifies insurance coverage and obtains authorizations and notifications throughout the patient’s treatment. Obtains all necessary signatures and documentation required by the patient’s insurance plan. Accurately and completely documents all information into the patient records system to ensure maximum reimbursement. Monitors and updates information regarding insurance data, authorizations, preferred providers and changes in patient’s treatment plan. Partners with the clinical care team and insurance provider to ensure continued coverage of patient’s care and maximum reimbursement and minimized financial impact to the patient.
3. Provides financial counseling to patients and their families and serves as the primary resource throughout the patient’s treatment. Discusses benefits and other financial issues with patients and/or family members during initial referral and during continuation of care. Advises patients on insurance and billing issues and options. Explains company financial policies and provides information as to available resources and avenues for alternative payment arrangements. Assists patients, families and team members in addressing insurance coverage gaps via alternative funding options.
4. Provides financial advocacy, assistance and support to patients and families, as needed. Assists patients who are un-insured to access other funding resources and completes required documents. Maintains current working knowledge of Medicare, Medicaid and other program benefits and criteria, particularly as they pertain to long-term care and low-income patients. May serve as a liaison between the facility and community in making community resources available to the patient and family.
5. Acts as a liaison between patient/PFS department/payer to enhance account receivables performance, resolve outstanding issues and/or patient concerns, and to maximize service excellence.
6. Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments.
7. May provide leadership and training to other members of the financial team and serves as a resource for internal and external customers.
8. Works independently under general supervision, leads and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. This position is an integral part of the care team, as they serve as the primary contact for all financial aspects of the patient’s care, both for internal and external customers. Internal customers include all levels of the clinical care team, as well as other administrative support positions throughout the facility and organization. External customers include patients and their families, physician office staff and third party payors.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Banner Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.
SUPERVISORY RESPONSIBILITIES
DIRECTLY REPORTING
None
MATRIX OR INDIRECT REPORTING
May provide leadership and training to other members of the financial team
TYPE OF SUPERVISORY RESPONSIBILITIES
N/A
Banner Health Leadership will strive to uphold the mission, values, and purpose of the organization. They will serve as role models for staff and act in a people-centered, service excellence-focused, and results-oriented manner.
PHYSICAL DEMANDS/ENVIRONMENT FACTORS
OE - Typical Office Environment: (Accountant, Administrative Assistant, Consultant, Program Manager)
Requires extensive sitting with periodic standing and walking.
May be required to lift up to 20 pounds.
Requires significant use of personal computer, phone and general office equipment.
Needs adequate visual acuity, ability to grasp and handle objects.
Needs ability to communicate effectively through reading, writing, and speaking in person or on telephone.
May require off-site travel
MINIMUM QUALIFICATIONS
Requires knowledge as typically obtained through an Associate’s Degree, with a focus in social work, healthcare administration or finance.
Requires knowledge of medical terminology and an understanding of all common insurance and payor types, authorization requirements and alternative financial resources as typically obtained through a minimum of three years of diversified experience in a hospital Patient Registration/Financial Services setting. Must have highly developed interpersonal, communications and human relations skills. Must also possess accurate and efficient keyboarding skills, strong organizational and time management skills and flexibility in responding to multiple demands. Employees working at Banner MD Anderson on the Banner University Medical Center Phoenix campus must possess a State of Arizona Department of Public Safety Level One Fingerprint Clearance Card at the time of hire and maintain the card for the duration of their employment. This is a requirement of the Whole Family Counseling Program held at this specific facility.
PREFERRED QUALIFICATIONS
Bachelors degree in social work, healthcare administration or finance preferred. Prior experience as a social worker or financial counselor preferred.
Additional related education and/or experience preferred.
DATE APPROVED 08/08/2021
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