Utilization Financial Specialist

Job scope:

Responsible for determining and collecting patients' financial responsibility at the time of service. Screens for available third party payer resources. Researches identified resources to determine and/or verify outpatient psychiatric benefits. Accountable for the accuracy of patient demographic and financial information recorded in the center clinical database. Responsible for oversight of patient accounts and provides assistance to reconcile patient account balances. Monitors financial and/or clinical data for individual payer requirements compliance. Ensures that all non-compliance issues are resolved prior to, or at the time of, the patients' next scheduled appointment. Maintains working knowledge of psychiatric procedures/services as necessary to monitor the accuracy of recorded versus scheduled procedures. Responsible for oversight of patient accounts, provides assistance and counseling aid in resolving patient account balances.

Education/licensure:

High School Diploma / GED Equivalent required; additional training / education in business practices preferred.

Current valid driver's license in state of residence.

Experience/Knowledge:

Minimum of 1 year customer service related experience working with the general public

Previous experience working in a healthcare setting preferred

Ability to perform basic mathematical calculations as necessary to oversee patient account and receipts required

Computer data entry experience/emphasizing speed and accuracy.

Requires advanced organizational skills and ability to manage multiple tasks.

Requires advanced interview and communication skills.

Functions as a team member and actively participates in continuous quality improvement activities.

Demonstrates aptitude for logical and deliberate problem solving and decision making

Physical requirements that are bona fide occupational qualifications essential to the performance of the job:

Moderate lifting and carrying up to a maximum of 20 pounds

Sitting for prolonged periods, walking, bending, stooping, kneeling and reaching above shoulder height

Motor skills necessary to operate essential office equipment