Lead Patient Financial - Patient Access

Job Details

Patient Access | Kettering | Full-time | First Shift

Responsibilities & Requirements

The Lead Patient Financial supports patient access and revenue cycle operations by guiding daily financial services activities, ensuring compliance with regulatory standards, and facilitating accurate and timely billing, collections, and account resolution. This role provides informal leadership to team members, assists with training, and champions process improvements to enhance patient financial experiences and operational reliability. Performs other duties as assigned. All job responsibilities are to be carried out in alignment with Kettering Health's mission, vision, values, and B Safe program.

Required Education:

• High school diploma or equivalent.

Required Work Experience:

• Three or more years of progressive experience in patient financial services, billing, or revenue cycle management, including at least one year providing informal guidance or training to peers.

Required Licenses, Certifications, and Registrations:

• None required by law.

Skills:

• Knowledge of healthcare revenue cycle and patient financial services processes
• understanding of billing, collections, and payer requirements
• proficiency with EHR and billing software
• strong communication and interpersonal skills
• ability to analyze data and identify trends
• attention to detail
• organizational and time management skills
• ability to facilitate training and provide peer guidance
• knowledge of HIPAA and confidentiality standards.

Competencies:

• Review an account for quality and confirmation and can demonstrate the ability to update all aspects of a patient account
• Assist patients with the completion of Financial Assistance Forms, HCAP Application and Medicaid Applications (if applicable)
• Demonstrate knowledge of all compliance or legally required registration forms, consents, literature and documents
• Employee demonstrates consistent hand hygiene practices

Preferred Qualifications

Additional Job Duties:

• Pre-screens uninsured and underinsured patients to identify potential financial assistance opportunities.
• Assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs.
• Ensures financial assistance applications are accurately filled out and complete before approval.
• Works in conjunction with on-site state social worker or outside eligibility vendor to assist and complete the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients’ eligibility.
• Initiates comprehensive interviews to determine each patient’s eligibility for Medicaid, hospital-sponsored charity care, and other programs.
• Provides patients with personalized financial assessment-based KH financial program guidelines, Insurance coverage and estimated patient liability.
• Initiates payment arrangements, collect patient liability after financial assistance has been determined and applied.
• Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility.
• Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.)
• Coverage at other Kettering facilities, if needed

Preferred Education:

• Bachelor's degree in Healthcare Administration, Business, Finance, or a related field, or equivalent combination of education and relevant experience.

Preferred Work Experience:

• Experience with Electronic Health Record (EHR) and billing systems
• prior experience in a lead or supervisory capacity within a healthcare revenue cycle environment.

Preferred Licenses, Certifications, and Registrations:

• Certified Revenue Cycle Professional (CRCP), Certified Healthcare Financial Professional (CHFP), or similar revenue cycle certification.

Overview

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.