Find & Apply For Financial Operations Specialist Jobs in Tupelo, Mississippi

JOB SUMMARY

The Specialist- Financial Assistance at North Mississippi Health Services is responsible for supporting the overall financial health of the organization by acting as a liason between patients and the hospital, guiding patients through medical costs, insurance, and payment options. The Specialist- Financial Assistance strives to optimize patient financial assistance and reduce bad debt by facilitating clear communication, eligibility checks, payments, and billing accuracy. This role operates under the guidance of the Patient Access Manager and requires an experienced individual with excellent analytical, organizational, and communications skills to review self-pay and underinsured patient accounts, manage demographic and insurance information, interface with patient and care teams to facilitate action and collect information, and maintain records to support a smooth process and optimize payment capture and coverage.

JOB FUNCTIONS

Patient Experience:

• Obtains crucial confidential patient identification information including patient records, signatures, and payment information repeatedly and ensures HIPAA guidelines are enforced
• Effectively communicates NMHS' organizational revenue cycle and financial policies including estimates, charity plans and payment options to patients and patient representatives Patient Financial Assessment & Support
• Meet with patients who are uninsured and have been referred for counseling
• Conduct patient interviews to determine patient demographics, financial status, and risk
• Notify the patient of the final outcome of their financial review
• Explain insurance coverage, expected out-of-pocket expenses, co-pays, deductibles, and non-covered services
• Provide cost estimates for scheduled services (ER, Inpatient, Outpatient, & Surgery)
• Responsible for maintaining Healthcare Coverage Assistance Fund (HCAF) spreadsheet
• Responsible for patient follow up and follow through Benefits Verification & Authorization
• Verify insurance eligibility, coverage level, and authorizations via systems, provider portals, & payors.
• Coordinate pre-certification and prior authorization in collaboration with central scheduling, patient access, clinical, & billing staff.

Collections & Financial Arrangements:

• Ensures team members are providing estimates to guarantors for procedures and collection attempted at the point of pre-registration or point of service
• Follow up on self-pay balances, missed payments, and aging accounts including calls, letters, notices, and referrals to collections
• Document all patient interactions, payment plans, and financial decisions in the system
• Responsible for check requests and premium payments to insurance
• Ensure payment is received and documented by payor
• Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislation/regulations

Financial Aid & Payment Plans:

• Assist with applications for Medicaid, charity care, ACA plans, financial aid, & etc.
• Set up payment plans, collect deposits or cash payments, and negotiate terms based on hospital policies

Contract Management:

• Maintains familiarity with payer methodologies to ensure accurate estimates are communicated with patients & system variances are communicated with leadership
• Manages expected reimbursement to ensure appropriate patient portion is collected prior to service
• Develops strategy for partnering with business office to ensure estimates & transparency are accurate
• Analyzes estimate variances to understand where/why deviations occurred
• Identifies trends and reports potential significant and recurring issues along with possible solutions to leadership

Inter and Outer Departmental Collaboration:

• Work closely with Patient Access, Case Management, Billing, Utilization Review, Social Services, and others
• Generate status reports, flag issues, and escalate to supervisor as needed
• Work in concert with Vendors to ensure Healthcare Coverage Assistance Fund (HCAF) process goes smoothly for NMHS and the patient

Compliance & Policy Adherence:

• Ensure compliance with state/federal regulations, hospital policies, and payer requirements
• Follow up on required third-party documentation and complete necessary filings.

QUALIFICATIONS

Education

• Bachelor's Degree In Business, Healthcare, Coding, or equivalent field. Required Or
• Associate's Degree Willing to consider 4 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required Or
• High School Diploma or GED Equivalent Willing to consider 8 years Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience beyond minimum requirement in lieu of Bachelor degree. Required Licenses and Certifications
• . . . Work Experience
• 1-3 years. Patient Access, Claims, Billing/ Follow-Up, or revenue cycle experience with degree. Required And
• 1-3 years. Experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs. Required Knowledge Skills and Abilities
• Working knowledge of Registration systems, Medicare/Medicaid/Third Party Liability/Workers Compensation
• Proficient in Microsoft Office (Word, Excel, and Outlook)
• Knowledge of applicable state and federal regulations relating to registering accounts and collecting at point of service
• Excellent negotiating and analytical skills
• Strong verbal and written communication skills
• Excellent interpersonal skills
• Effectively and efficiently prioritizes and organizes tasks
• Develops, implements/evaluates projects (timely & efficient manner)
• Ensures accurate and timely collection of all appropriate patient estimates
• Ensures effective monetary management of Deposits
• Ensures timely and accurate processing of accounts in accordance with best practices, defined workflow, procedures, and applicable legislature/ regulations
• Gathers and relays information with knowledge, tact, and diplomacy
• Experiences daily contact with co-workers, patients, payers, and other

NMHS/NMMC

staff members

• Exhibits strong written and verbal communication skills
• Reflects a positive, caring attitude toward clients, patients, staff, and the public we serve
• Evaluates and coaches reporting employees to accomplish major goals and objectives
• Develops, implements/evaluates projects in a timely & efficient manner
• Effectively communicates information to staff, internal and external customers Benefits A vailable
• Continuing Education
• 403B Retirement Plan with Employer Match Contributions
• Pet, Identity Theft and Legal Services Insurance
• Wellness Programs and Incentives
• Referral Bonuses
• Employee Assistance Program
• Medical Benefits
• Dental Benefits
• Vision Benefits
• License + Certification Reimbursement
• Life, Long-Term and Short-Term Disability, Group Accident, Critical Illness and Hospital Indemnity Insurance
• Employee Discount Program

Other:

• Early Access to Earned Wages
• Tuition Assistance
• Relocation Assistance
• Paid Time Away
• Special Employee Rates at NMMC Wellness Centers _We believe a career is more than just a career - it's a calling.

Our teammates' \"True North\" is what calls them to health care; it's their passion. At North Mississippi Health Services, we believe in helping you leverage and connect that passion with a much greater purpose that impacts people you know and love._ #NMHSConnections