Under the general direction of the Yale Medicine Administration Prior Authorization/Patient-Estimation Supervisor, the Account Assistant 4 is primarily responsible to determine the patient responsibility and provide an estimate of the costs of services prior to the services being rendered. The Account Assistant 4 is also responsible for collecting on those estimates prior to the service being rendered.
Please refer to the essential duties below for more detail.
- Utilizing EPIC work queues and online carrier tools and/or third party tools, the Financial Counselor will determine if the patient is self-pay or has a high deductible plan.
- Review patient’s medical chart to determine services being rendered.
- Communicate with insurance carriers and research patient benefits.
- Based on information gathered from carrier, create an estimate of patient responsibility for services to be rendered.
- Make contact with patient prior to a specific service being rendered to discuss and explain the financial estimate of services and collect payment.
- Record estimate information in EPIC on patient’s accounts.
- Work with patient to resolve any existing outstanding balance on patient’s account.
- Post payments collected.
- Must have thorough knowledge and understanding and be able to monitor and reconcile any credit balance left on a patient’s account.
- Communicate with physician offices and YNHH as needed, utilizing professional discretion to determine appropriate communication with physician’s office.
- Answer incoming patient estimate calls and prepare estimates as required.
- Assist departments with questions and issues relating to the authorizations/referrals.
- Ability to work independently and meet specific timelines.
- Perform clerical functions incidental to account activity
- Other related duties as assigned.
Required Education and Experience
Four years of related work experience, two of them in the same job family at the next lower level, and a high school level education; or two years of related work experience and an Associate Degree; or an equivalent combination of experience and education.
Required Skill/Ability 1:
Superior oral and written communication skills. Independent decision making.
Required Skill/Ability 2:
Knowledge and thorough understanding of insurance benefits and ability to interpret and discuss deductibles and co-insurances with patients. Excellent customer service skills and work well as a team player.
Required Skill/Ability 3:
Excellent attendance and reliability. Highly energetic and motivated with the ability to work under pressure and handle and maintain a high volume of accounts.
Required Skill/Ability 4:
Ability to maintain a high degree of tact, diplomacy and understanding in dealing with patients and maintain a high level of confidentiality in discussing personal and financial matters.
Required Skill/Ability 5:
Excellent organizational skills.
Preferred Education, Experience and Skills:
At least two years medical billing and customer service experience. Working knowledge of medical insurance authorizations and referrals preferred. Working knowledge of ICD-10 and CPT codes. EPIC experience. Understanding of Credit Balance process in EPIC. Working knowledge of Microsoft Office. Spanish speaking preferred.
Background Check Requirements
All candidates for employment will be subject to pre-employment background screening for this position, which may include motor vehicle, DOT certification, drug testing and credit checks based on the position description and job requirements. All offers are contingent upon the successful completion of the background check. Please visit www.yale.edu/hronline/careers/screening/faqs.html for additional information on the background check requirements and process.
The intent of this job description is to provide a representative summary of the essential functions that will be required of the position and should not be construed as a declaration of specific duties and responsibilities of the particular position. Employees will be assigned specific job-related duties through their hiring departments.
Affirmative Action Statement:
Yale University considers applicants for employment without regard to, and does not discriminate on the basis of, an individual’s sex, race, color, religion, age, disability, status as a veteran, or national or ethnic origin; nor does Yale discriminate on the basis of sexual orientation or gender identity or expression. Title IX of the Education Amendments of 1972 protects people from sex discrimination in educational programs and activities at institutions that receive federal financial assistance. Questions regarding Title IX may be referred to the University’s Title IX Coordinator, at TitleIX@yale.edu, or to the U.S. Department of Education, Office for Civil Rights, 8th Floor, Five Post Office Square, Boston MA 02109-3921. Telephone: 617.289.0111, Fax: 617.289.0150, TDD: 800.877.8339, or Email: firstname.lastname@example.org.