UW Medicine Financial Access Clearance Team Services Department (FACT): This position’s primary location is at the Sandpoint Non-Seattle Campus (within Magnuson Park) but depending on operational needs this position may be located at any of the following UWM Campuses; Sandpoint Non-Seattle Campus (Magnusen Park), Harborview Medical Center (HMC), University of Washington Medical Center (UWMC) or other University of Washington Medicine (UWM) organization non-campus locations within the FACT department.
The Financial Access Specialist 1 (FAS-1) will, under general supervision, participate in on-the-job training to learn to coordinate the insurance clearance process for Inpatient planned and unplanned admits, for Outpatient Surgery,
Clinic Procedures, high dollar Infusion, and/or Radiology high dollar Procedures, as well as, various functions associated with obtaining and verifying the insurance coverage and benefits for facility and professional services, which may include emergency services, inpatient hospitalization, transportation, rehab, therapies, nursing home placement, home health care/durable equipment, outpatient surgeries, clinical visits, and specialized procedures; also verifies L&I, Crime Victims and other coverages.
Work under direct supervision, preforming assigned work. This position coordinates the insurance clearance process for Inpatient planned and unplanned admits, for Outpatient Surgery, Clinic Procedures, high dollar Infusion, and/or Radiology high dollar Procedures.
Performs the various functions associated with obtaining and verifying the insurance coverage and benefits for facility and professional services , which may include emergency services, inpatient hospitalization, transportation, rehab, therapies, nursing home placement, home health care/durable equipment, outpatient surgeries, clinical visits, and specialized procedures; also verifies L&I, Crime Victims and other coverages.
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Under general supervision, the FAS-1 will:
Review scheduled appointments through patient work queue
Obtain insurance authorizations through assigned payer administrators
Verifying/document patients eligibility and benefits in Epic auth/cert
Document progress of each case in Epic auth/cert
Refer uninsured patients for Medicaid/Charity eligibility screening
Prepare estimates of fees upon request from Patient Care Consultants
Review payment options with patients
Keeps daily productivity log as assigned
Provides internal customers on-going status of inpatient/outpatient authorization by payer
Collect payments
Process payments using cash drawer in Epic
Call patients to provide overview of limited medical benefits and Out-of-Pocket cost
Prepare Notice of Non-Coverage form for patient signature
Call referring providers to obtain referrals or to initiate authorization
Provides internal customers on-going status of inpatient/outpatient authorization from the payer for surgery
Coordinates and explains options to patients related to potential financial
responsibilities including charity/financial assistance, possible Medicaid eligibility, financial implications of proceeding with or without authorizations, and in and out-of-network ramifications
Confer with Financial Clearance supervisor if coverage status unclear or other information unclear.
Interpret hospital’s policies, procedures and services to patients, patient representatives, inter/intra-hospital departments and community facilities.
Ensures patient demographic information is accurate in EPIC and REG, through patient contact or insurance verification information.
Verify eligibility of patient’s insurance and document information.
Verify patient benefits and document information.
Verify or obtain an referral when it is required, prior to the service
Requirements:
High School diploma or GED certificate plus two years of experience in a medical office setting; OR, equivalent education/experience.
Source: Indeed.com
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