Financial Assistance Specialist 1

The Financial Assistance Specialist 1 requires extensive knowledge of Managed Care, Medicaid, Medicaid Disability, Medicare, Healthcare Marketplace Insurance, Hillsborough County Health Care Program (HCHCP), Health Care Responsibility Act (HCRA) and Victims of Crime, as well as having expertise in Customer Service and exceptional time management and organizational skills. The Financial Assistance Specialist 1 works diligently to fund the unfunded/underfunded patients and/or consumers. The Financial Assistance Specialist 1 will submit, track and follow Medicaid, HCHCP and HCRA applications to completion, until a denial or an approval is received. Responsible for performing all job duties in accordance with mission, vision and values of Tampa General Hospital.

Essential Functions:

• Interviewing Private Pay and underinsured patients to determine eligibility for government Financial assistance programs.
• Assessing patient financial capabilities.
• Preparation of charity care application, including the Utilization Letter (EA Letter) for illegal aliens as required by the Department of Children & Families (DCF).
• Acquisition of all necessary documentation as required by the respective Government Agencies, including Social Security Disability (SSI/SSD), which may require additional contact with the patient or the patient’s family, even after discharge.
• Submission of the assistance application to appropriate agency within specified timely filing requirements.
• Tracking assistance applications, documenting location, status, approval or denial.
• Attending DCF hearings to appeal cases that have been closed in error or denied.
• Notifying the Financial Assistance Specialist Team Lead of approvals or denials.
• Explain financial accountability to the patient and/or guarantor/family.
• Obtain Lifetime Reserve Days letter on Medicare patients
• Follow up on all W/C and Auto admissions missing billing information.

Education Qualifications:

• High School Diploma or GED

Experience Qualifications:

• Must have a minimum of two (2) years Financial Assistance, Patient Access or Patient Accounting experience.
• An equivalent combination of education and years of experience may be considered.

Skills and Abilities:

• Proficient with word processing, databases, spreadsheets and EMR platforms and applications.
• Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
• Knowledge of CMS, TJC, AHCA regulations as pertaining to hospital registration.
• Extensive knowledge of Medicaid, Medicaid Disability, Medicare, Commercial Insurance, Healthcare Marketplace Insurance, Hillsborough County Health Care Program (HCHCP) application processes, Health Care Responsibility Act (HCRA), Victims of Crime, PCIP and Healthcare Exchange.
• Knowledge of Financial Assistance/Charity processes.
• Knowledge of Patient Access processes.
• Skill in collecting personal financial and medical information.
• Ability to communicate effectively in both oral and written form.
• Ability to handle difficult and stressful situations with professional composure.
• Ability to process and handle confidential information with discretion.
• Ability to analyze, organize and prioritize work while meeting multiple deadlines.
• Ability to recognize appropriate medical coverage order.
• Ability to identify and/or calculate patient responsibility (copays, deductible, out-of-pocket maximums, co-insurance).