Medical Billing chez CommonSpirit Health

CHI Health St. Elizabeth, founded by the Sisters of St. Francis of Perpetual Adoration in 1889, is a full-service, 260-bed, nonprofit regional medical center in Lincoln, Neb. St. Elizabeth specializes in the treatment areas of newborn and pediatric care, women’s health, burn and wound, cardiology, oncology, emergency medicine, orthopedics and neuroscience.

This position contributes to the CHI Health vision and mission by the creation, implementation and maintenance of an effective workflow to assist our patients with the financial responsibility of healthcare. This job is responsible for assisting patients by providing information to patients who require assistance navigating through their insurance benefits and financial options in accordance with established business objectives and applicable regulatory requirements. They will collaborate with clinics and other facilities under the supervision of the Patient Financial Services supervisor, to make sure they are assisting the clinics and/or patients in an efficient manner, meets customer/ facility needs and are compliant with internal policies/standards/procedures and applicable regulatory requirements.

Essential Function

• Performs financial counseling process on patients prior to treatment, which includes discussion of health insurance benefits (if applicable) billing practices, pre-collections, and payment arrangements.
• Assists in identifying financial resources available to the patient including Medicaid, Marketplace plans, COBRA, financial assistance, etc.
• Obtains initial and subsequent pre-authorizations for services as needed. Communicates approval/denial of prior authorizations back to clinical staff in a timely manner.
• Provide patients information on costs of service, payment methods and alternatives to payments including other financial options based on eligibility
• Work with clinic staff to proactively identify patients with potential need for financial assistance options and/or financial counseling on upcoming services.
• Provide answers to reimbursement questions regarding health-plan eligibility, benefit issues, co-pay requirements and medical referral requirements, in compliance with facility guidelines and requirements.
• Receive and process charity care and/or financial assistance applications on PB only accounts in a timely manner.
• Prepare estimates of procedures, calculates payment requirement, and inform patient of acceptable payment arrangements on balance, both current and previous.
• Review patient accounts and determine eligibility for medication co-pay card programs.

Experience (required and preferred):

• Experience in health care revenue cycle functions to include insurance, registration, collections or customer service : Preferred