Senior Financial Assistance Specialist

GENERAL SUMMARY:
The Senior Financial Assistance Specialist serves as the hospital’s subject matter expert for patient financial assistance programs, providing comprehensive financial counseling to patients prior to or at the time of service.   This position evaluates financial circumstances, identifies eligibility for federal, state and local assistance programs, facilitates enrollment in Medicaid and hospital charity care, prepares federally compliant Good Faith Estimates, and educates patients regarding available financial resources.

This position directly supports revenue cycle performance by reducing uncompensated care, increasing reimbursement through third-party assistance programs, improving patient financial experience, and ensuring compliance with federal and state regulations governing patient financial assistance and price transparency.  

Full-time benefits include medical, vision, dental, and prescription drug coverage, as well as HSA/FSA, life insurance, long-term disability insurance, retirement plans, and generous Paid Time Off.

QUALIFICATIONS:

Minimum Education, Training & Experience (includes licenses or certifications): 

Education / Licensure:

• High School Graduation or GED.
• Washington State Medicaid Navigator Required within 30 days of hire.

Experience:

• Five or more years of direct experience in healthcare financial services, patient financial services, revenue cycle, financial counseling, or a related healthcare setting

ESSENTIAL FUNCTIONS / RESPONSIBILITIES (but not limited to):

• This position exercises independent judgment in determining patient eligibility for financial assistance programs, developing payment solutions, ensuring regulatory compliance, and coordinating financial resources across multiple departments.  The incumbent serves as a primary resource for complex patient financial matters and contributes directly to organization financial performance through reimbursement optimization and reduction of uncompensated care.
• Conduct comprehensive financial assessments with patients and guarantors to determine available financial assistance.
• Assist patients with completing Medicaid or Charity Care applications, gathering required supporting documentation, and monitoring application status through eligibility determination.
• Assist with eligibility issues and assist with appeals when appropriate.
• Prepare and provide Good Faith Estimates in accordance with applicable Federal and State requirements for underinsured and self-pay patients
• Ensure compliance with the No Surprises Act and CMS regulations. Support organizational compliance with the No Surprises Act, CMS requirements, and applicable Federal and State regulations.
• Maintain knowledge of:
  • CMS regulations
  • Medicaid eligibility requirements
  • Hospital charity regulations
  • No Surprises Act
  • Good Faith Estimate requirements
  • Price Transparency regulations
  • HIPAA
• Maintain complete and accurate documentation in Meditech.
• Provide exceptional customer service during financially stressful situations.
• Train and mentor new financial specialists.
• Serve as a resource for Patient Access, Referrals, and scheduling staff.
• Participate in quality improvement initiatives.
• Analyze financial assistance trends.
• Recommend process improvements.
• Maintain productivity and quality metrics.
• Assist with community outreach regarding financial assistance programs. 
• Willingness to learn and use emerging technologies, including automation tools, software applications, and artificial intelligence.
• Performs other duties as assigned.