Purpose of Position: Under direct supervision, conducts investigations in a health care setting to determine the eligibility of applicants for medical assistance payment programs or the ability of patients and their legally responsible relatives to pay for hospital or health care charges and takes the necessary actions to bill and collect for these services; explores alternative sources for payment for health care setting services rendered; codes, verifies and modifies demographic and insurance data obtained from source documents and enters such data into a computerized system; performs billings and collections functions in order to obtain maximization of health care setting’s revenue; all personnel perform related work.
Examples of Typical Tasks:
1. Informs patient of health care setting rates; performs in-depth interviews with patients, families, relatives and friends in an office setting or the health care setting, during field investigations, and/or by telephone to determine patients’ and/or legally responsible relatives’ ability to pay for services rendered.
2. Contacts outside agencies, organizations, insurance carriers and employers to obtain necessary information about potential sources of revenue.
3. Acts as a liaison with social services and home care agencies.
4. Refers patients to various health care setting departments and outside agencies, such as Medicaid, New York State Unemployment Insurance, Social Security and Public Assistance for possible benefits.