Fairview Health Services · 1 day ago

Patient Financial Services Cost of Care Representative (REMOTE)~

St Paul, MN

Full-time

Remote

Entry Level

2+ years exp

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Responsibilities

Obtain required demographic, coding & payor information

Provide customer friendly education on required data elements for calculating payment and pricing and scope of service that will be provided

Able to convert complete information into customer friendly education

Verify insurance eligibility via on-line access or by phone

Utilize familiarity with payors and plans to confirm coverage

Model estimates for self-pay and insured customers using required tools

Understand Managed care payment methodologies including APC, DRG, per diem, fee schedules, etc.

Analyze output for reasonableness using knowledge of payment methodologies and charge structures

Adjust data and re-calculate if necessary

Finalize estimates

Communicate outcome of estimate

Call customer within established timeframe to communicate estimate and send follow up if requested

Provide education to customer regarding additional questions

Receive customer feedback regarding the estimate

Direct customer to other resources as needed

Respond to all concerns / inquiries in a timely and professional manner

Provide response to customers that meets or exceeds turn-around time expectations including providing live estimates to patients over the phone for procedures with estimate templates created

Accountability to follow through on turn-around time requirements

Self-manage daily workload to follow through on and complete issues

Ability to work independently and apply critical thinking

Take initiative to prioritize and meet deadlines

Escalate issues as needed to meet and/or exceed customer expectations

Participate in meetings with internal and external departments as requested

Qualification

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Healthcare customer serviceCost of care information