Full employer posting
Job Overview This position, under Revenue Cycle Management, is responsible for working with patients who express difficulty in paying for medical services, assisting patients with the complex Medical Assistance process (MN health care programs), and collaborating with hospital staff to address discharge barriers related to coverage. This position works directly with medical staff, nursing, insurance carriers and ancillary departments to assist families in obtaining healthcare and financial services, as well as to determine and educate the patient of their financial liabilities and potential payment sources.
Monday-Friday / 7:30 to 4:00 Responsibilities Coordination of all activities related to the screening and application of MN Medical Assistance, Fairview Financial Assistance programs, and other public medical assistance programs, while working with patients to ensure applications are completed. Activities will include but are not limited to: In-person and virtual discussions with the patient or patient representative about income, assets, household composition, disability status, citizenship, etc.
Assessment of the patient’s situation to determine program eligibility and exhaust all paths to coverage solution Advance appropriate application submission with the patient to the applicable county or state representative Monitor the application process and coordinate follow-up activities with the patient on any missing verification information or spenddown scenarios. Submit appeal on denied applications to county or state when eligibility requirements are met.
Ensure that all applicable outstanding balances are incorporated into the application and request back-dating when necessary Succinct and timely documentation of all activities above Complete complex Medical Assistance applications that require a higher level of Minnestoa Healthare Program proficiency – Emergency Medical Assistance, Medical Spenddowns, SMRT (Disability), MA-Employed Persons with Disabilities, Long Term Care.
Maintain working knowledge of Fairview Financial Assistance eligibility criteria and additional MN Medicaid program nuances that contribute to a person’s eligibility criteria (examples: minimum value standard, life event changes, Medicare program enrollment and eligibility, mixed households, case renewals, qualified health plans, guardianship, employee sponsored insurance, COBRA, overlapping state coverage, etc.). Conduct case consultations with Care Coordination, Financial Assistance Navigator I or II or other clinical care teams as needed.
Organize efforts with the Inpatient Care Team to help resolve barriers to discharge through the medical assistance process (Acute Rehab, LTC/SNF, Dialysis, Homecare). Adhere to the organization’s Financially Unsecured Policy through above screening and application activities. Timely escalation with all pertinent information to applicable level of leadership for further review.
Review and resolve accounts that are complex and require a higher degree of expertise and critical thinking. Review and resolve accounts that are complex and require a higher degree of expertise and critical thinking. Required Qualifications A.
A./A. S. business, healthcare or related field or commensurate experience of 4 years in addition to minimum experience requirement. 3 years in a customer service or human services role with 2 or more years in a Financial Assistance role or experience with Minnesota Health Care Programs. Prior experience working with county programs or charity care programs.
B. S./B. A. in Social Work, Human services, Healthcare or related field. 5 years in healthcare or insurance organization.
Prior experience working with patients in an acute care setting Benefit Overview Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract Compensation Disclaimer An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions.
Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
About the role
This position, under Revenue Cycle Management, is responsible for working with patients who express difficulty in paying for medical services, assisting patients with the complex Medical Assistance process (MN health care programs), and collaborating with hospital staff to address discharge barriers related to coverage.