Summary:
Under the general supervision of the Manager Patient Access and within established hospital and departmental policies and procedures screens and interviews patients guarantors and/or families reviews patients medical condition in the context of eligibility for disability assistance. Reviews the financial and dependency circumstances and status eligibility of patients who have inadequate or no medical coverage. Determines potential eligibility for financial assistance programs to be applied against medical bills. Provides transportation support and representation at fair hearing appeals and assists applicants with obtaining the necessary documentation to apply for financial assistance.

Responsibilities:
Assumes an advocacy role with patients and or families and their surrogates in regard to the resolution of outstanding patient accounts. Arranges and negotiates payment conditions and plans and advises and counsels patients in regard to available resources from which payments can be made.



Reviews large balances of in-house cases on a daily basis and regularly contacts Case Management personnel to determine severity of patient�s condition and expected prognosis.



Interviews patients and family members relative to their financial and dependency status or other factors which may help promote eligibility for medical assistance or other state and federal programs.



Represents on a liaison basis the hospital�s finance function concerning �at risk� patient accounts. Such contacts to involve other departments federal and state agencies attorneys and third party payers. Reviews patient account information with Senior Patient Advocate to determine collection potential of each high risk patient.



Secures legal counsel and aid for patients and families. Assists patients in obtaining documentation necessary to apply for public assistance. Assists patients with fair hearing appeals if denied public assistance.



Contacts patient�s family members and/or friends and relatives to develop avenues leading to account resolution. Sets appointments with appropriate social agencies and organizations to provide the patient with the needed assistance. Provides transportation and accompanies patient to such agencies as needed.



Researches obtains from patient all forms and documents such as death certificates birth certificates alien registration cards medical certifications financial data etc. and compiles said documents necessary to establish patient eligibility for SSI Medical Assistance and other state and federal; programs.



Makes home visits to assist patients with the completion of application forms etc. Works with case management personnel in regards to establishing coverage that will help move patients to rehabilitation and other post-hospital facilities.



Transports patients to and accompanies patients through substance abuse rehabilitation programs when needed to obtain welfare.



Maintains a continuing review of files records and other forms of documentation on state and federal programs and regulations.

Other information:
BASIC KNOWLEDGE:

Knowledge of accounting third party coverage social services psychology etc. normally acquired through completion of a related Bachelor�s Degree program or the equivalent.



Current knowledge of state and federal resources available for needy and disabled including familiarity with forms and documents necessary to file appeals on denied claims.



Knowledge of third party payor guidelines and coverage limitations; Lifespan accounting procedures government regulations including provisions of the COBRA Act.



Demonstrated interpersonal skills to effectively communicate with patients family members Lifespan employees and state and federal representatives and other government service agencies.



Ability to operate a CRT or PC to access information and to prepare and maintain related records and reports.



Demonstrated knowledge and skills necessary to provide care patients with consideration of aging processes human development stages and cultural patterns in each step of the care process.



EXPERIENCE:

One or more years Business Office experience and third party experience.



Must have a good driving record meet and maintain appropriate and valid drivers license in order to operate motor vehicle as required by the Federal Motor Carrier Safety Regulations and in accordance with the Lifespan Fleet Risk Control Policy.



WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Sitting for long periods of time at a workstation requiring the continuous use of a computer and telephone in an area not accessible to the public.



May have to do moderate walking depending on location of the assignment.



Ability to lift up to ten pounds.

Lifespan is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status.   Lifespan is a VEVRAA Federal Contractor.

Location: The Miriam Hospital USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union