From Bassett Healthcare Network's posting. “We” and “our” refer to the employer.
The best thing about this role
Are you looking to make a difference by improving the health of our patients? Here you will find an innovative culture that is patient-focused and dedicated to making a difference. We are committed to helping the population we serve, and our communities, achieve optimum health and enjoy the best quality of life possible.
What you'll do
The Patient Eligibility and Support is an integral member of the Bassett Cancer Institute, provides financial counseling and guidance for patients through various resources. Performs pre-determination of eligibility / authorization for selected treatments, procedures and visits prior to date of service. Determines self-pay status of patients and works closely with other Bassett clinical departments and support programs to assist patients in understanding and meeting financial obligations. Forms close working relationships with Cancer Institute staff, billing staff, and front-end staff assuring the best possible front-end processes for full and complete capture of revenue and patient services. Provides Presumptive Eligibility and Medicaid determination for patients. Assists patients in acquiring public health plans as appropriate. Works closely with local Departments of Social Services within Bassett’s service area as well as Bassett’s health plans and local Community Service organizations providing Facilitated Enrollment services.
Provides complete Insurance Support Services to front end processes as well as to Bassett patients
Determine eligibility status of assigned patients scheduled as self-pay within 5 business days of DOS
Refer true self-pay patients to appropriate clinic staff as well as CSP program
As appropriate determine self-pay patients' eligibility for other public insurance programs
Provide presumptive eligibility and application assistance for appropriate patients as needed
Verifies Medicaid status of selected Medicaid patients within 5 business days of DOS vides verification and eligibility status on "high ticket" outpatient procedures as assigned
Work closing with CSP program, develops process to reduce MedSpar recalls from front end work
Work closely with billing office to identify front end denial trends and develops intervention actions
Provides coordination with the patient, insurance company, and hospital on the complete pre-certification process, which includes second opinions and tertiary referrals
Process additional information requests and coordinate with the insurance biller on requests for letters of medical necessity from and to insurance companies
Review patient chemotherapy protocols and determine insurance benefits and patient responsibility
Assist with SSI or SSD
Assist and/or process STD (short term disability) forms
Assist with payment arrangements for patients with outstanding patient balances
Assist fund management
Assist patients with treatment cost analysis
Educate patients about financial resources
Assist with obtaining or understanding insurances
Information Management
Develop working knowledge of Bassett payer system and financial classifications
Assist system administrators in providing coaching for end users on system data entry
Maintain department specific data bases and data management processes
Performs other duties as requested and observed by supervisor or manager
What we need from you
Education:
2 Year/Associate Degree in health related field, preferred
Experience:
Preferred minimum 3 years of work-related experience:
in healthcare, eligibility/verification processes and systems working with uninsured and Medicaid patients knowledge of NYS presumptive eligibility/facilitated enrollment processes knowledge of public health insurance programs and other community resources available to the disadvantaged experience working with diverse groups of individuals from a variety of cultural, socioeconomic and educational backgrounds
Experience in one-to-one counseling and coaching, preferred
Skills:
Accountability
Advocacy
Attention to Detail
Communication
Community Relations
Computer Skills
Networking
Responsibility
Time Management
Physical Requirements:
Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met
Bassett Healthcare Network’s commitment to our employees includes benefit programs carefully designed with the needs and values of all our employees in mind. Many of the benefits we offer are paid fully or in large part by Bassett. Our generous benefits offerings include:
Paid time off, including company holidays, vacation, and sick time
Medical, dental and vision insurance
Life insurance and disability protection
Retirement benefits including an employer match
And more!
Specific benefit offerings may vary by location and/or position.
Pay Range
Salary is based on a variety of factors, including, but not limited to, qualifications, experience, education, licenses, specialty, training, and fair market evaluation based on industry standards. The above compensation range represents a good faith belief of the compensation range by Bassett Healthcare Network, and its entities and affiliates, at the time of this posting or advertisement.
Pay Range Minimum:
USD $16.98/Hr.
Pay Range Maximum:
USD $25.47/Hr.
We love the difference people bring
We provide equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex (including pregnancy, childbirth, or related condition), age, national origin or ancestry, citizenship, disability, marital status, sexual orientation, gender identity or expression (including transgender status), genetic predisposition or carrier status, military or veteran status, familial status, status as a victim of domestic violence, or any other status protected by law.
Responsibilities
The Patient Eligibility and Support is an integral member of the Bassett Cancer Institute, provides financial counseling and guidance for patients through various resources. Performs pre-determination of eligibility / authorization for selected treatments, procedures and visits prior to date of service. Determines self-pay status of patients and works closely with other Bassett clinical departments and support programs to assist patients in understanding and meeting financial obligations. Forms close working relationships with Cancer Institute staff, billing staff, and front-end staff assuring the best possible front-end processes for full and complete capture of revenue and patient services. Provides Presumptive Eligibility and Medicaid determination for patients. Assists patients in acquiring public health plans as appropriate. Works closely with local Departments of Social Services within Bassett’s service area as well as Bassett’s health plans and local Community Service organizations providing Facilitated Enrollment services.
Provides complete Insurance Support Services to front end processes as well as to Bassett patients
Determine eligibility status of assigned patients scheduled as self-pay within 5 business days of DOS
Refer true self-pay patients to appropriate clinic staff as well as CSP program
As appropriate determine self-pay patients' eligibility for other public insurance programs
Provide presumptive eligibility and application assistance for appropriate patients as needed
Verifies Medicaid status of selected Medicaid patients within 5 business days of DOS vides verification and eligibility status on "high ticket" outpatient procedures as assigned
Work closing with CSP program, develops process to reduce MedSpar recalls from front end work
Work closely with billing office to identify front end denial trends and develops intervention actions
Provides coordination with the patient, insurance company, and hospital on the complete pre-certification process, which includes second opinions and tertiary referrals
Process additional information requests and coordinate with the insurance biller on requests for letters of medical necessity from and to insurance companies
Review patient chemotherapy protocols and determine insurance benefits and patient responsibility
Assist with SSI or SSD
Assist and/or process STD (short term disability) forms
Assist with payment arrangements for patients with outstanding patient balances
Assist fund management
Assist patients with treatment cost analysis
Educate patients about financial resources
Assist with obtaining or understanding insurances
Information Management
Develop working knowledge of Bassett payer system and financial classifications
Assist system administrators in providing coaching for end users on system data entry
Maintain department specific data bases and data management processes
Performs other duties as requested and observed by supervisor or manager
Qualifications
Education: 2 Year/Associate Degree in health related field, preferred
Experience: Preferred minimum 3 years of work-related experience:
in healthcare, eligibility/verification processes and systems working with uninsured and Medicaid patients knowledge of NYS presumptive eligibility/facilitated enrollment processes knowledge of public health insurance programs and other community resources available to the disadvantaged experience working with diverse groups of individuals from a variety of cultural, socioeconomic and educational backgrounds
Experience in one-to-one counseling and coaching, preferred
Skills: Accountability
Advocacy
Attention to Detail
Communication
Community Relations
Computer Skills
Networking
Responsibility
Time Management
Physical Requirements: Sedentary Work - Exerting up to 10 lbs of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking or standing are required only occasionally, and all other sedentary criteria are met
LAYIQ is an independent job-discovery service. This listing does not imply a partnership with or endorsement by the employer. Review the original posting for current details and availability.
