The primary purpose of this position is to ensure that appropriate reimbursement resources are in place for services provided at AHMC Seton Medical Center. The Patient Financial Advisor ensures that appropriate reimbursement resources are in place for services provided to ensure the financial viability of the facility. This includes the
following: 1) Accurate and timely assessment of payer and patient legal liability; 2) Compliance with industry state, federal and local regulations and requirements; 3) Adherence to government and non government program requirements; 4) Effectively communicating with patients as to program requirements, personal payment liabilities, and options for care and placement that allow for informed decisions by the patient and his/her family while protecting the financial interest of the hospital facility; 5) Requesting prior authorization from the payers for patients that have been or are in the process of being admitted into the hospital's acute care departments including but not limited to ICU, Telemetry, and Medical/Surgical Units.

5-9 years Patient Accounting experience in a large metropolitan medical center, large freestanding clinic, or chain of free standing clinics. Must effectively operate a 10-key adding machine by touch, and must type 40 wpm with minimal errors (5 or less). Must demonstrate effective interpersonal skills and communication skills.

 Demonstrated effective expertise in insurance confirmation and insurance benefit follow-up and credit and collections.
 Demonstrated knowledge of the role that Utilization Review, Discharge Planning (Case Management), Admissions, Medical Information Department, and related departments all have on the impact of reimbursement.
 Positive group dynamics and a firm commitment to quality performance of the department, and a firm commitment to the comprehensive achievement of the department goals and objectives
 Demonstrated knowledge of the legal requirement of collections.
 Gather and analyze all patient information on medical needs, financial resources and circumstances, residential status, duration/type of care medically appropriate, patient eligibility for private, federal, state and county program coverage; provide full documentation for billing within limits specified by the appropriate agency and coverage source.
 Interpret and relay provisions and requirements of applicable private, federal, state and county aid programs to patients and physicians, explaining any and all obligations and rights under the given program.

 Provide all alternatives at hand and counsel patients regarding realistic financial ability to pay for medical care.
 Assist in budget when necessary. 
 Interview and correspond with patients, relatives, attorneys, employers and welfare agencies to obtain information, explain Regional policies, receive payment and arrange payment plans which fulfill the financial policy requirements of the Region.
 Evaluate a wide variety of deeds, life insurance policies, negotiable securities, and miscellaneous collateral to determine security value as appropriate.
 Obtain real estate property and other financial information and liens, assignment of insurance policies or benefits and third party liability liens as appropriate, all within the legal policies and procedures set by federal, state and industry standards.
 Determine patient third party insurance coverage and validate benefits pertinent for services for benefits payment.
 Inform and advise the physicians of the patient's financial status, interpret third party insurance, and interpret and relay as appropriate the financial impact on the region and physician office, with all alternatives as apply in a given situation.
 Resolve problems involving interfacing of various private and government agencies to ensure appropriate billing and reimbursement for services which have been provided by the Region.
 Apply sensitivity to the patient's medical situation in the counseling of a patient about his/her financial relationship to services provided so as to minimize impact during care while assuring that the patient can make informed choices about same.
 Interact professionally with Regional/Hospital staff to obtain all pertinent information protecting patient confidentiality while ensuring all components required for reimbursement are obtained.
 Any and all other functions required to ensure appropriate coverage and reimbursement for services are forthcoming from private, federal, state or county sources, protecting the financial viability of the Region.
 Age-Related Competency: Has demonstrated knowledge of and competence in age-related patient care, as defined and documented in department standards.
 Workplace Safety: Is aware of and works within hospital and departmental safety guidelines, including reporting potential hazards and hazardous behavior. Uses appropriate body mechanics and lifting devices, as needed, for all work assignments.

LANGUAGE SKILLS: Ability to read, analyze, and interpret technical procedures, bank and financial forms/reports/documentation, patient accounting system screens/reports, and policies and procedures. Ability to write reports, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

MATHEMATICAL SKILLS: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent.

REASONING ABILITY: Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical and financial instructions. Ability to estimate staff workloads and to re-direct workflow as appropriate. Ability to analyze data and identify trends or patterns

QUALIFICATIONS: The incumbent must be able to perform each essential duty satisfactorily. The requirements below are representative of necessary knowledge, skill, and ability. Reasonable accommodations may be made to enable people with disabilities to perform essential functions.

AHMC Seton Medical Center and AHMC Seton Medical Center is a 377-Bed facility encompassing acute care and post-acute services.