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DEPARTMENT PURPOSE STATEMENT
Our purpose is to create a positively memorable and inspiring “Wow” experience for each and every customer we serve, each and every time we have the opportunity to serve them. We distinguish ourselves by our ability to listen and empathize with others and by the extraordinary efforts we make to deliver uncompromising levels of service. We are here to guide our customers, both patients and their families, through a seamless healthcare experience that provides tailored assistance and education that is responsive to their individual needs and expectations. Our goal is to continue to value and delight our patients with experiences that nurture powerful customer relationships that will last a lifetime. We take accountability for every aspect of our patients’ experience and continuously strive through every interaction we engage in to prove ourselves as stewards of the NorthBay way.
JOB SUMMARY
At NorthBay Health the, Financial Verification Ambassador , Accurately, efficiently and timely pre-registers, and completes financial analysis activities for all scheduled and unscheduled inpatient admissions, outpatient procedures, and ambulatory services by scheduling appointments and procedures, verifying eligibility, benefits, coverage limitations, and collecting and/or making arrangements for patients to meet deductible/share of cost and co-payment responsibilities.
Responsible for obtaining all necessary authorizations as well as coordinating with case management to meet any reporting/utilization review requirements to ensure maximum reimbursement. Conducts educational conversations with patients explaining the details of their coverage eligibility and benefits, including but not limited to information on coordination of benefits, the status of required authorizations, estimated charges, outstanding deductibles, share of cost, co-pays and out-of-pocket obligations and outstanding balances from previous visits.
Takes initiative to resolve patient issues to the best of your ability and when required, refer patients to other members of the Patient Access or Financial Counseling team, as well as other departments within the health system as appropriate. Maintains and promotes an attitude of professionalism and empathy as reflected by courteous actions, maintenance of confidentiality and appropriate presentation of self and consistently demonstrate excellent oral and written communication skills. Assists the QA/Training Coordinator and the Exceptional Experience Coaches with training and department quality improvement projects. Consistently meets or exceeds department expectations for productivity, financial stewardship and patient satisfaction metrics.
Qualifications
Education/Training:. Associate Degree preferred.
Licensure/Certification: Patient Access and/or Revenue Cycle relevant certification from a nationally recognized healthcare credentialing organization required within 12 months of hire.
Experience:
Five or more years of customer engagement experience in a healthcare revenue cycle environment required.
Excellent oral and written communication skills with and ability to effectively articulately thoughts into a useful and meaningful discussion. Intensive experience with insurance health plans and knowledge of billing regulations required and experience with phone-based customer service is strongly preferred.
Expertise is required in the application of knowledge in the areas listed below:
Differentiation of the unique characteristics of the following insurance types: Medi-Cal, Medicare, Managed Care, Indemnity and Workers Compensation including eligibility requirements and benefit coordination.
Impact of completeness and accuracy that the registration/admission process has on successful claims processing and receipt of payment
Impact of completeness and accuracy that the registration process has on the delivery of patient care
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