Department:OH1HS_70001_000 Pre Planned Services
Expected Weekly Hours:40
Position Purpose:At Mount Carmel, we work to continuously inspire one another. Here, all are welcome. It is this culture of humility and compassion that sets Mount Carmel apart. We see the big picture and do the right thing. That means a dedication to the well-being our both our colleagues and the patients they serve.
Job Description Details:
Excellence in care takes the dedication and commitment of not only our front-line care teams, but of the specialized professionals that support all aspects of our mission. Colleagues in Finance, HR, Marketing and more keep Mount Carmel operating at the highest standard. And we provide leading education training and development opportunities to keep you working at yours.
The Patient Financial Specialist II obtains demographic, clinical, financial and insurance information in the process of appointment making for patient tests and procedures. In addition, the PFS II also performs pre-registration and registration activities including response to real-time eligibility verification and financial clearance. Incumbent provides instructions to the patient on test preparation, prints and mails patient itineraries if lead time is sufficient and validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Obtains and processes signed physician orders to ensure clinical documentation for care delivery.
- Performs activities that relate to patient scheduling, pre-registration, registration, real-time eligibility verification, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other intradepartmental functions.
- Determines proper scheduling requirements and/or limitations according to requested test(s)/procedure(s) and scheduling resources (equipment, staff, room, and etc.) in a timely manner to ensure customer satisfaction, maintain patient flow, and appropriate utilization of the service area. Coordinates add-on and same-day appointments with the service area, as required. Ensures proper test sequencing with minimal patient delays when multiple testing is required.
- Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions. Communicates with various ancillary departments to ensure an accurate schedule and that all reports are properly distributed.
- Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).
- Obtains signed physician orders for all tests and procedures from physicians/offices for testing and procedures or advises patient they must present a physician’s order on the date of service.
- High School Diploma
- Experience: Must possess a working knowledge of medical terminology, and data entry skills.
- Effective communication skills
- Excellent interpersonal skills are necessary in dealing with peers, internal, and external customers. Accuracy, attentiveness to detail and time management skills are required.
- Incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively.
Discovering opportunities, support and excellence – all while making a real difference in patients’ lives – begins at Mount Carmel. Find a new beginning and advance your career with us.
Mount Carmel and all its affiliates are proud to be equal opportunity employers. We do not discriminate on the basis of race, gender, religion, sexual orientation or physical ability.
Trinity Health's Commitment to Diversity and Inclusion
Trinity Health employs more than 120,000 colleagues at dozens of hospitals and hundreds of health centers in 21 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.