HCA, Hospital Corporation of America Patient Benefit Advisor - Riverside Community Hospital in Riverside, California
GENERAL SUMMARY OF DUTIES–Responsible for conducting eligibility screenings, assessment of patient financial requirements, and counseling patients on insurance benefits and co-payments. The Benefits Advisor serves as a liaison between the patient, hospital, and governmental agencies; and is actively involved in all areas of case management.
DUTIES INCLUDE BUT ARE NOT LIMITED TO: • Screen and evaluate patients for existing insurance coverage, federal and state assistance programs, or hospital charity application.
• Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment.
• Ensures appropriate signatures are obtained on all necessary forms.
• Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination.
• Complete and file applications.
• Initiate and maintain proper follow-up with the patient and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation.
• Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately.
• Document progress notes to the patient’s file and the hospital computer system.
• Participates in ongoing, comprehensive training programs as required.
• Follows policies and procedures to contribute to the efficiency of the office.
• Covers and assists with other office functions as requested.
• Will be required to make field visits as necessary.
• Adheres to and supports organizational IT&S standards, policies, and procedures.
• Adheres to Code of Conduct.
• Performs other duties as assigned.
KNOWLEDGE, SKILLS & ABILITIES • Working knowledge of medical terminology, practices and procedures, as well as laws, regulations, and guidelines. • An understanding of patient confidentiality to protect the patient and the clinic/corporation. • Demonstrated communication, problem solving and case management skills and the ability to act/decide accordingly. • Ability to collect, synthesize and research complex or diverse information. • Exceptional customer service and the ability to plan organize and exercise sound judgment.
• College degree preferred or high school diploma (equivalent).
EXPERIENCE • A minimum three years of hospital/medical business office experience with insurance procedures and patient interaction.
• Strong familiarity with a variety of the field’s concepts, practices and procedures.
Job: *Admitting Registration Clerical & Scheduling
Title: Patient Benefit Advisor - Riverside Community Hospital
Location: California-Riverside-Riverside Community Hospital
Requisition ID: 26573-146323