What are the responsibilities and job description for the Patient Cost Estimation Specialist I position at Nemours?
Job Description
The Patient Cost Estimation Specialist reports to the manager of the Cost Estimation Team. The Specialist utilizes high-level customer service, healthcare finance and revenue cycle knowledge, and excellent communication skills. The Specialist has a detailed understanding of price transparency regulations, including but not limited to the No Surprises Act of 2020, and how it relates to challenges in a complex health care environment. This person is the primary contact for patient-families and colleagues seeking to understand financial care of services to be delivered.
The Patient Cost Estimation Specialist works closely with authorization, financial advocate, clinical representatives, and business stakeholders in order to most accurately provide estimated cost for patient-families. This person has extensive knowledge of patient benefit design and care delivered by Nemours in order to effectively help a patient-family understand how it relates to their scheduled procedure or service. They do this in a way that upholds a patient-centered model of care delivery and Nemours’ values and standards of behavior.
Responsibilities
As one of the nation's premier pediatric health care systems, we've made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions. It's a promise that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention.
Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive environment. All Nemours Associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.
Nemours aspires to have its workforce and providers reflect the rich diversity of the communities we serve. Candidates of diverse backgrounds, race and ethnicity, religion, age, gender, sexual orientation, and those committed to working with diverse populations and conversant in multicultural values are strongly encouraged to apply. Please click here to review Nemours Anti-Racism Statement (nemours.org) .
To learn more about Nemours and our commitment to treat every child as if they were our own, visit us at www.nemours.org .
The Patient Cost Estimation Specialist reports to the manager of the Cost Estimation Team. The Specialist utilizes high-level customer service, healthcare finance and revenue cycle knowledge, and excellent communication skills. The Specialist has a detailed understanding of price transparency regulations, including but not limited to the No Surprises Act of 2020, and how it relates to challenges in a complex health care environment. This person is the primary contact for patient-families and colleagues seeking to understand financial care of services to be delivered.
The Patient Cost Estimation Specialist works closely with authorization, financial advocate, clinical representatives, and business stakeholders in order to most accurately provide estimated cost for patient-families. This person has extensive knowledge of patient benefit design and care delivered by Nemours in order to effectively help a patient-family understand how it relates to their scheduled procedure or service. They do this in a way that upholds a patient-centered model of care delivery and Nemours’ values and standards of behavior.
Responsibilities
- Identify how an individual’s planned service will relate to their specific payor and plan design, including but not limited to tiers and benefit levels.
- Based on historical data, patient-specific information, and authorizations, identify the appropriate CPTs for which to estimate.
- Deliver and communicate the patient cost estimate to both patient-families and providers, as applicable.
- Discuss financial options with families. Collect pre-payments from patient-families.
- Meet all regulations in regard to the No Surprises Act.
- Builds and maintains effective enterprise-wide relationships with clinical team members, business operations, various department representatives, authorization specialists, financial advocates, and other stakeholders, as applicable.
- High School Diploma Required
- Healthcare experience required
- Certified Revenue Cycle Representative (CRCR) required within first 12 months
As one of the nation's premier pediatric health care systems, we've made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions. It's a promise that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention.
Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive environment. All Nemours Associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.
Nemours aspires to have its workforce and providers reflect the rich diversity of the communities we serve. Candidates of diverse backgrounds, race and ethnicity, religion, age, gender, sexual orientation, and those committed to working with diverse populations and conversant in multicultural values are strongly encouraged to apply. Please click here to review Nemours Anti-Racism Statement (nemours.org) .
To learn more about Nemours and our commitment to treat every child as if they were our own, visit us at www.nemours.org .