Job description

Overview:

• All positions are located in Fresno/Clovis CA *

Community Medical Centers has been providing central California with the highest level of care available in the region. Community Regional Medical Center measures up with top hospitals nationally and is the 3rd largest in California! With 685 beds, we are home to the only comprehensive Burn and Level I Trauma center between Los Angeles and Sacramento. The 56,000 square-foot emergency department is one of the largest and busiest in California! We have an 84-bed Level III NICU and plan to significantly expand pediatric specialty care. Our hospital serves 2.5 million people within 9 counties, averaging a daily census of 641 patients. We're affiliated with UCSF as a teaching facility; trained 3,000 Medical Doctor's to date plus continuous invests in research and training grants.

Responsibilities:
The Patient Financial Counselor 1 provides financial counseling to patients by interviewing patients to verify insurance coverage, establish payment arrangements, determine eligibility for financial assistance and other related activities to maximize reimbursement to the hospital for services rendered.

Accountabilities

1. Reviews online or credit balance accounts in work queues for proper financial information and authorization.

2. Contacts insurance companies, government agency, patients, attorneys or necessary agency to establish payment source.

3. Communicates with patients or insurance payers regarding financial sources for their bill.

4. Maintains quality and accounts receivable days within department goals or documents showing acceptable progression to goal.

5. Researches and processes accounts for refunds. Appeals denied claims.

6. Verifies accuracy of payments received from third party payers. Follows up on payments in a timely manner.

7. Reviews billed accounts for accuracy of discounts, allowance adjustments and makes corrections as necessary. Identifies accounts that qualify for charity and process accordingly.

8. Makes collection calls to patients and third party payers.

9. Conducts follow-up activity with the patients awaiting Federal/State agency eligibility approval and performs transfer of account to external agency as necessary.

10. Forwards updated insurance accounts to billing department. Coordinates with insurance verification, admission nurses, physician's offices, cashiers, Case Management and billing as required. Performs other duties as assigned.

Qualifications:
High school diploma/GED. PREFERRED: Two years hospital/medical experience in a business office setting. Associate's Degree in Accounting or Office Management.

Disclaimers:

• Pay ranges listed are an estimate and subject to change.
• Per the CDPH order, all healthcare workers are required to be vaccinated for COVID-19 or have an approved exemption and test regularly.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

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