职位描述
岗位职责Responsibilities:•Case managementoPrepare estimated cost according to treatment plans and hospital’s pricing principleoConfirm Direct Billing eligibility and insurance policy benefitoUpdate insurance companies about insured patient’s costs and make sure the expenses are covered by a guarantee letteroCommunicate with patients about their payment method, clearly discussion of the deposit / guarantee status and payment plans•NegotiationoCommunicate and convince third party payers to obtain payment guaranteeoSupplement information to third party payers as required, such as medical justification, pricing structure, estimation details, etcoAppeal on behalf physician and/or management team for denied cases oEscalate complicated cases to upper intervention if neededoConduct case study to support supervisor and managers to propose appropriate payment solution for any special casesoIntroduce membership program to qualified patientoProvide financial counseling service to patient•AnalysisoAnalyze financial patterns together with coding / Revenue Cycle / management team, such as the use of CPT code, billing group, etcoAnalyze insurance trends•Report insurance performances to TPP and management team to support relationship maintenance•Other assignments by supervisor or managers任职条件Qualifications:•Associate college degree required•Customer service experience, at healthcare business preferredSkills:•Language skills: fluent in Chinese and English (both oral and written)•PC skills: good at Microsoft office tools, Excel and/or other analytical tools preferred•Communication skills: good at approaching staff, co-workers, and supervisors•Negotiation skill: able to “sell” hospital services to convince payers•Must work well under pressure and be able to work on multiple tasks simultaneouslyKnowledge:•Good understanding of medical terminology, curiosity to cumulate more medical knowledge•Good understanding of insurance industry•Good understanding of customer service•Knowledge of healthcare business职位概述Summary of Responsibilities:?Responsible for ensuring the timely and accurate review of any situation requiring a medical determination prior to final payment for all orthopedic cases?Conduct the study and analysis on orthopedic department部门概述上海和睦家医院(SHU)是纳斯达克上市公司美国Chindex集团（股票代码：CHDX）和上海长宁区中心医院共同组建的合资医院，于2004年12月1日开始营业。上海和睦家医院的宗旨是：在家庭般温馨舒适的就诊环境里，为患者提供独特的、全方位的医疗服务。上海和睦家医院具有自己特定的建院目的，是一家获得JCI国际认证的综合性医院，拥有来自全球的高水平医务人员，同时可与全球40多家保险公司直接结算。上海和睦家医院设有24小时开放的急诊室，可为患者提供门诊和住院服务，医院还配备了一流的手术室、放射科、药房和化验室。上海和睦家医院在选择具有国际背景的高级医生和本土专家时，不仅考察其培训经历和专业知识是否卓越，还要考察他们的同情心、同理心以及是否真正有兴趣在多元文化环境中工作。除了具有高水平的医疗团队外，上海和睦家医院还与来自地方教学医院及亚洲地区医疗机构的医学教授和顾问建立了良好的工作关系。上海和睦家医院是值得您信赖的健康伙伴！
