Reporting to the Nursing Home Administrator, the Patient Finance Coordinator is responsible for planning, coordinating and implementing alignment of Resident/Patient care with third party payers, guarantors and responsible parties in order to produce optimal financial outcomes. This position is required to perform job duties with a high degree of independent decision making and judgment.
Type of supervision exercised: none Jobs reporting to this position: none
EDUCATION:
High School diploma or equivalent required.
Associate’s degree plus additional formal training in business administration or management preferred.
WORK EXPERIENCE:
1-2 years experience in a long term care facility required.
3 years experience as a Skilled Nursing facility Business Office Manager preferred
SPECIAL EMPLOYMENT REQUIREMENTS:
Must have excellent written and verbal communication skills and interpersonal skills.
Must have strong negotiation skills and good analytical abilities.
Ability to set and change priorities quickly as the situation warrants.
Ability to work independently.
Working knowledge of personal computers required.
Must have thorough knowledge of SNF Medicaid application process.
Must have ability to understand and interpret third party payer contracts.
Valid PA diver’s license and reliable means of transportation; travel required.
PHYSICAL DEMANDS:
Sedentary Work_:_ duties require exerting up to 10 lbs. of force occasionally (approx 10-33% of shift) and/or a negligible amount of force frequently (approx 33-66% of the time) to lift, carry, push, pull, or otherwise move articles such as files.
Involves sitting most of the time, but may involve walking or standing for brief periods of time.
Ability to transport self and health information throughout Allied facilities is required.
Visual acuity must be accurate to read and interpret reports, data, medical records and other documentation.
ACCIDENT OR HEALTH HAZARDS:
No accident or health hazards inherent in position.
WORKING CONDITIONS:
Works in a well-lit office or SNF environment.
Required Skills
+--------------------------------------------------------------------------+ | CHARACTERISTIC DUTIES & RESPONSIBILITIES OF JOB: | | | | E = Essential Element NE = Nonessential Element | +--------------------------------------------------------------------------+ | 50% Works to ensure timely completion and submission of PA 600 and MA | | 51. (E) | +--------------------------------------------------------------------------+ | 25% Contacts patients, families, or place of employment to expedite | | collection of accounts receivable. Completes Advanced Beneficiary | | Notices and appeals as needed. Requests/secures deposit funds from | | patients/family when no insurance coverage is involved. Reviews past | | records of specific patients to determine credit rating or other | | pertinent information. Reviews local newspapers to secure estate notices | | and check against related financial records. Contacts trustees, | | executors, etc., as necessary to secure payment for services rendered. | | Resolves and/or clarifies policy regulations and payments for patients | | when staff is not able to resolve such questions. Serves as financial | | counselor to patients and/or families that inquire about their financial | | condition either via Admissions, Social Services or Patient Advocate. | | (E) | +--------------------------------------------------------------------------+ | 10% Monitors criteria for level of care changes; coordinates and tracks | | Medicare exhaust, technical denial and UR non-covered letters. (E) | +--------------------------------------------------------------------------+ | 5% Intervenes with RNAC’s and therapists to resolve issues of potential | | denial. (E) | +--------------------------------------------------------------------------+ | 5% Monitors patient’s need for special equipment, high cost medication | | and appointments with outside providers in coordination with 3rd party | | payers. (E) | +--------------------------------------------------------------------------+ | 5% Provides intervention techniques to handle needs and concerns of | | residents and family, referring to outside agency as necessary; attends | | POC meetings as necessary. (E) | +--------------------------------------------------------------------------+
Required Experience
+--------------------------------------------------------------------------+ | CHARACTERISTIC DUTIES & RESPONSIBILITIES OF JOB: | | | | E = Essential Element NE = Nonessential Element | +--------------------------------------------------------------------------+ | 50% Works to ensure timely completion and submission of PA 600 and MA | | 51. (E) | +--------------------------------------------------------------------------+ | 25% Contacts patients, families, or place of employment to expedite | | collection of accounts receivable. Completes Advanced Beneficiary | | Notices and appeals as needed. Requests/secures deposit funds from | | patients/family when no insurance coverage is involved. Reviews past | | records of specific patients to determine credit rating or other | | pertinent information. Reviews local newspapers to secure estate notices | | and check against related financial records. Contacts trustees, | | executors, etc., as necessary to secure payment for services rendered. | | Resolves and/or clarifies policy regulations and payments for patients | | when staff is not able to resolve such questions. Serves as financial | | counselor to patients and/or families that inquire about their financial | | condition either via Admissions, Social Services or Patient Advocate. | | (E) | +--------------------------------------------------------------------------+ | 10% Monitors criteria for level of care changes; coordinates and tracks | | Medicare exhaust, technical denial and UR non-covered letters. (E) | +--------------------------------------------------------------------------+ | 5% Intervenes with RNAC’s and therapists to resolve issues of potential | | denial. (E) | +--------------------------------------------------------------------------+ | 5% Monitors patient’s need for special equipment, high cost medication | | and appointments with outside providers in coordination with 3rd party | | payers. (E) | +--------------------------------------------------------------------------+ | 5% Provides intervention techniques to handle needs and concerns of | | residents and family, referring to outside agency as necessary; attends | | POC meetings as necessary. (E) | +--------------------------------------------------------------------------+