Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
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Facility: Imagenetics Building
Location: Sioux Falls, SD
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Provides financial advocacy counseling to patients/families including topics of insurance coverage, treatment coverage, prompt pay and financial hardship discounts to patients and family members. Responsible for screening self-pay patients and evaluate them to determine eligibility in various governmental and non-governmental programs to ensure patients are assisted in meeting their financial obligations. Discuss agreeable payment plans with qualified patients. Responsible for identifying all sources of potential payers including Commercial Insurance, Private Insurance, etc. Also responsible for providing and completing the Financial Assistance Application form and assisting patients in the process of applying for any benefits for which they may be eligible. Determine patient eligibility for assistance programs through interviews and screening processes. Complete an insurance benefit investigation for all new/transferring patients as appropriate. Completes prior authorization as necessary. Works with patients to ensure continued eligibility and ensure re-certifications. Contacts appropriate agencies to obtain information and paperwork necessary to process patient's assistance applications. These resources can include state caseworkers, banks, employers, Social Security Administration, medical facilities, and insurance companies. Assist with patient assistance programs offered by pharmaceutical companies, state governments and nonprofit groups. Educates patients on various sponsorship programs available based on eligibility including but not limited to Medicare, Supplemental Security Income, Social Security Disability, Medicaid programs, County eligibility, and Indian Health Services. Assist with completing FMLA and Disability paperwork requirements. Assist patients to navigate the Medicare System to ensure benefit start dates are accurate, correct insurance is primary, ESRD benefits, etc. Ensures avenues of reimbursement or assistance are pursued for uninsured and underinsured patients. Refers patients to other agencies for assistance when needed and discusses the financial statement process relating to payment options and hospital assistance, including grants. Follows up in obtaining missing insurance information, patient demographics, etc., on patient accounts for the proper handling in the billing office. Complete price estimates. Completes annual review of insurance pamphlet and coverage options as mandated by Conditions for Coverage. Communicates with supervisor and various departments such as Nursing, Physicians, Case Management, Social Work, Patient Access, Patient Relations, Quality Resource Management and Social Services to address patient concerns. Complies with other job-related responsibilities as directed by Leadership. Demonstrates a caring and respectful attitude to all patients, family members, visitors and fellow employees as defined in the mission and values of the organization.
Bachelor’s degree in social work, case management, public relations or related field required. In lieu of degree, consideration may be given to six years equivalent work experience.
Previous experience in healthcare services or health insurance would be beneficial, but not required.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to firstname.lastname@example.org .
Job Function: Revenue Cycle
Req Number: R-28841