Job Description

Description

Summary/Objective
Under limited supervision the Patient Financial Specialist helps patients register for services and navigates the complexities of Medicaid eligibility and financial assistance. Utilizing standardized OPM workflows and the AssistPoint (AP) platform this role ensures that qualifying patients receive necessary coverage and that the provider can bill Medicaid accurately. The Specialist acts as a critical link between the patients financial need and successful revenue cycle outcomes.

Essential Job Functions

Conduct comprehensive patient intake by collecting demographic contact and insurance information.

Execute precise data entry into the Electronic Health Record (EHR) system to ensure seamless downstream billing.

Verify active Medicaid coverage and benefits through state portals and real-time eligibility tools.

Act as a patient advocate by assisting with Medicaid enrollment renewals and the gathering of required documentation (e.g. ID income verification and residency proof).

Determine Coordination of Benefits (COB) to identify whether Medicaid is the primary or secondary payer.

Partner with third-party payers to resolve coverage discrepancies.

Provide empathetic clear explanations regarding Medicaid benefits eligibility requirements and billing inquiries.

Utilize active listening and probing questions to identify and resolve patient financial concerns.

Maintain meticulous patient records in strict accordance with HIPAA HITECH and JCAHO regulations.

Safeguard corporate and client assets by following all organizational security policies.

Represent Omega in client-facing meetings forums and discussions.

Communicate directly with patients to:

Gather and validate required demographic income and financial information

Explain eligibility requirements in clear patient-friendly language

Support patients through the Medicaid enrollment process

Evaluate patients for Medicaid eligibility and Charity Care programs including:

Reviewing financial documentation

Assessing household income and resources

Determining appropriate program qualification per state and facility guidelines

Independently designs and develops training materials from the ground up including curricula documentation and supporting resources tailored to audience needs. Successfully delivers training sessions that result in demonstrable knowledge transfer skill adoption and improved performance among trainees. Specifically on the following:

Medicaid registration processes

Charity care eligibility evaluation

Patient financial management workflows

Key Success Indicators/Attributes

Ability to prioritize and multi-task in a fast-paced changing environment.

Demonstrate ability to self-motivate set goals and meet deadlines.

Demonstrate excellent verbal communication skills with the ability to effectively explain complex billing and insurance concepts to patients.

Strong active listening skills to understand patient concerns and provide appropriate resolutions.

Maintain courteous and professional working relationships with employees at all levels of the organization.

Work in accordance with corporate and organizational security policies and procedures understand personal role in safeguarding corporate and client assets and take appropriate action to prevent and report any compromises of security within scope of position.

Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.

Skill in operating a personal computer and utilizing a variety of software applications is essential.

Understanding of HIPAA and basic reimbursement principles.

Demonstrated ability to present information clearly and confidently in both formal and informal settings (presentations structured meetings trainings working sessions client check-ins)

Demonstrated ability to independently design and develop training materials from the ground up including curricula documentation and supporting resources tailored to audience needs

Adapts communication style to diverse audiences while maintaining professionalism and clarity.

Ability to work across multiple systems (EMR PMS digital portals).

Supervisory Responsibility

No

Work Environment

This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and soft phones.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job the employee is occasionally required to stand; walk; sit; use hands to finger handle or feel objects tools or controls; reach with hands and arms; balance; stoop kneel crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision distance vision peripheral vision depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work

This is a full-time position. Each employees schedule must be between the hours of 6:00 AM PST to 9 PM PST Monday through Friday with the specific schedule for each employee to be agreed upon by the employees manager and the employee taking into account the needs of the client. This position occasionally requires long hours and weekend work.

Travel

None

Required Education and Experience

1-2 years of experience in medical billing reimbursement processes or insurance terminology.

Proven background in customer service or call center environments (healthcare setting preferred).

Proficient computer skills and experience with electronic health records (EHR/EMR) or billing software systems.

High School diploma or equivalent additional education in healthcare administration or related field is a plus.

Experience developing training materials and delivering curriculum to team members

Experience presenting information to clients while protecting the brand and interests of Omega.

Preferred Education and Experience

Associate or bachelors degree in healthcare administration or a related field.

Prior experience specifically within the Epic ecosystem.

Familiarity with JCAHO coding compliance reimbursement and HIPAA/HITECH.

Additional Eligibility Qualifications

N/A

Security Access Requirements

In addition to the specific security access required by the employees client engagement the employee will have access to the Omega set forth in the Standard Field Employee profile.

Microsoft Office

ADP

Oracle

E1- Field Employee

Standard Employee

Standard

Equal Employment Opportunity:

Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race color religion national origin gender age sexual orientation gender identity or expression marital status mental or physical disability protected veteran status and genetic information or any other basis protected by applicable law. Omega Healthcarealso prohibits harassment of applicants or employees based on any of these protected categories.

Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application interview or any other part of the hiring process please contact Human Resources at

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice. Employee may perform other duties as assigned.

Required Experience:

IC

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