Utilization Financial Specialist

Located in Texarkana, TX

Salary: $16/hour

Position: Utilization Financial Specialist

Location: Texarkana, TX

Hours: M-F, 8a-12p, 1p-5p

Pay: $16/hour

Benefits: Full benefits once perm!

 

Position Summary

Performs technical and procedural functions as necessary to insure the successful billing for services provided by clinic staff.  Responsible for determining and collecting patients’ financial responsibility at the time of service.  Screens for available third party payer resources.  Researches identified resources to determine and/or verify outpatient psychiatric benefits.  Accountable for the accuracy of patient demographic and financial information recorded in the center clinical database.  Monitors financial and/or clinical data for individual payer requirements compliance.  Ensures that all non-compliance issues are resolved prior to, or at the time of, the patients’ next scheduled appointment.  Maintains working knowledge of psychiatric procedures/services as necessary to monitor the accuracy of recorded versus scheduled procedures.  Monitors clinical services documentation for corporate and funding source compliance prior to submission to the center clinical database.

 

Education/licensure:

Bachelor’s with business concentration; Associate degree with 2-3 years related experience; High School Diploma / GED Equivalent supported by courses in business practices, with 3-5 years related experience in medical billing / collections.

 

Job Duties:

Demonstrates capacity to interact with patients on a professional and sensitive level. Uses positive key phrases to promote dignity and respect.  Performance based on patient survey and supervisor observation.

Promotes patient education and understanding of the financial assessment process.  Performance based on patient survey and supervisor observation.

Demonstrates interviewing skills necessary to obtain accurate financial information.  Performance based on supervisor observation and formal evaluation.

Demonstrates thorough knowledge of the application of the rule with regards to purpose, scope and target population. Performance based on completed assessments in evidence of compliance with the rule.

Demonstrates thorough knowledge of technical components of the financial assessment.  Applies correct number of family members, calculates allowable income/earnings accurately, applies special provisions and extraordinary expenses correctly and establishes the correct monthly ability to pay as evidenced in individual record and formal evaluation.

Obtains required documentation of reported patient income/expenses and/or defers to the manager when an individual refuses to provided requested documentation.  Performance expectation as evidence of proof of income/expenses in the individual record and/or documentation of refusal and referral.

Demonstrates thorough knowledge of the technical components of the financial assessment.  Applies the correct number of family members, calculates the allowable income/earnings accurately, applies special provisions and extraordinary expenses correctly and establishes the correct monthly ability to pay as evidenced in the individual record and formal evaluation instruments.

Obtains required documentation of reported patient income/expenses and/or defers to the manager when an individual refuses to provided requested documentation.  Performance expectation as evidence of proof of income/expenses in the individual record and/or documentation of refusal and referral.

Correctly implements written notification provisions outlined in the rule governing charges for community based services.  Correctly applies and collects for services in accordance with the individual’s assessed monthly ability to pay at the time of service. Performance based on review of monthly collections.   Maintains evidence of collection procedures and attempts for difficult cases.  Defers to clinic manager as appropriate for clinical judgment regarding persons who refuse to meet their assessed financial responsibilities.

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