A Financial Case Manager is responsible for providing various levels of support which includes assisting individuals and families with determining insurance eligibility and assisting with insurance claims. The job description and duties are included on the Financial Case Manager Resume as – understanding, establishing, and managing credit; creating and maintaining a personal budget; helping sick or disabled individuals and families, providing various levels of support, assisting and determining insurance eligibility, assisting with insurance claims, maintaining a personal budget, offering to patients in a hospital, hospice, and other institutionalized settings, and providing financial case management assistance.
Those seeking this job role must mention on the resume the following skills and abilities – knowledge of case management principles, healthcare management, and reimbursement; effective communication skills, time management skills, familiarity with professional and technical emerging knowledge, the ability to multitask, compassionate with teamwork skills. A degree in a related healthcare field is commonplace among job applicants.
Summary : To obtain a successful position within a hospital or administrative setting that will allow me to utilize my skills and knowledge in maintaining a constant pursuit of the organizations maximums healthcare reimbursements and increase patient/physician satisfaction scores.
Skills : Medical Denials Management, Heathcare Reimbursment, Collections, Customer Service.
Description :
Utilized Tenet Healthcare Disputed Claims Management Program for trending and analyzing Healthcare Reductions of Reimbursement.
Monitored and Maintained of various departments, i.e. Admitting, Case Management, And Regional Business Office.
Developed strategies and mechanisms to ensure timely follow-up of claims denial.
Reviewed and updated denials data to enable accurate compiling of statistics, coordinate meetings, develop office procedures, establish and maintain filing system, maintain logs, proofread documents, research information for needed department based on compiled denial data.
Assisted in ensuring pre-certification, re-certification and concurrent review processes are performed and are complete, accurate and on time.
Developed and implemented communication mechanisms that promote accurate and timely reimbursement of cases.
Collaborated with collection staff in a timely follow-up of denial and appeal activities.
Experience
10+ Years
Level
Senior
Education
B.A.
Financial Case Manager Resume
Summary : Over 20 years experience in the Financial Case Manager with proven success in Patient Access Management. Strong sense of responsibility, accountability and self-motivation. Excellent written, oral and interpersonal communication skills, with solid analytical, problem solving and leadership skills.
Identified cases needing a support order by reviewing case documentation, completing legal forms, gathering income information, and performing support calculation to establish support order.
Requested, reviewed and evaluated affidavits for accuracy and information necessary to initiate action, including obtaining sworn statements.
Received modification requests in writing and review requests to decide whether a modification is warranted.
Investigated non-custodial parents' assets, employment and availability of health insurance to decide ability to pay.
Used information and research and apply guidelines to calculate correct support obligation.
Obtained and verified information to assist in enforcement established orders.
Analyzed financial records for collection potential and initiate the appropriate collection method.
Experience
10+ Years
Level
Senior
Education
B.S. In Business Administration
Financial Case Manager Resume
Headline : As a Financial Case Manager, responsible for Gathering, tracking and communicating financial and insurance information for an assigned caseload of patients/clients and their representatives in order to inform the treatment team of third party requirements that impact treatment plan, maximize prompt collection for services, and prevent bad debt.
Skills : Budgeting, Communication, Microsoft Access.
Description :
Responsible for tracking and reporting moneys used in services provided to customers in a Behavioral Health, Chemical Dependency Treatment environment.
Monthly, quarterly and yearly reported of contractual monies used to county and state.
Scheduled of all Department Managers meetings.
Ordered of all office supplies.
Provided full range of interstate support services.
Provided on-going guidance and feedback to Admitting staff, Clinical staff, HIM staff, Business Office staff and Hospital Core Administrative Directors regarding denial reasons, appeals, outcomes, needed training and implementation of actions plans for prevention of disputed claims and all new/current managed care contractual requirements.
Explained financial requirements to patient or responsible party and collect deposits and applicable deductibles.
Experience
5-7 Years
Level
Executive
Education
MS
Financial Case Manager Resume
Objective : Dedicated Financial Case Manager motivated to maintain customer satisfaction and contribute to company success. Committed to delivering success through effective personnel and workflow management. Versed in customer support in high call volume environments. Superior computer skills and telephone etiquette.
Skills : Microsoft Office, Financial Skills.
Description :
Responsible for ensuring financial responsibility for all patients within the outpatient setting.
Responsible for ensuring that all insurance referrals are appropriately authorized.
Ensured point of service collections.
Served as a financial resource to front end staff.
Responsible for providing patient education on financial responsibilities.
Verified insurance coverage for services rendered.
Responsible for making recommendations to improve revenue collection at point of service.
Experience
2-5 Years
Level
Executive
Education
BS
Financial Case Manager Resume
Summary : Financial Case Manager with 25 years in the home health care environment with experience in Clinical IT training and support. Created streamlined and effective processes that revitalized departmental productivity and work flows. Wrote interdepartmental policies and procedures. Strong Project Planning and Management skills that ensure on time delivery of project goals and milestones. Created training formats and user manuals for clinician transitions to point of care system.
Skills : Notary public, NYS Certified application Counselor, Quckbooks, MS Office, Excel, Word, PowerPoint, AdvancedMD, SRS, Solution Reach.
Description :
Created a streamlined and efficient model for managing agency population requiring direct ongoing communication with third party payer case managers.
Responsible for ongoing patient authorizations for all home health patient population with third party payers requiring pre-authorization for service.
Developed and established patient financial file.
Established effective method of communication with clinical staff of patient medical status and need for ongoing home health services.
Developed collaborative relationships with clinicians and team managers in the process of establishing patient information communicated to insurance case managers.
Created clinician training manual for submission of funding plans of care.
Produced statistical spreadsheet for weekly reporting of insurance population and active patient census.
Experience
10+ Years
Level
Senior
Education
GED
Financial Case Manager Resume
Summary : Seeking a Financial Case Manager position of challenge and responsibility, which will offer the opportunity for personal growth and career advancement.
Skills : MS office, Multitaking.
Description :
Created funding plans that diminish the barriers to admitting clients.
Determined the extent of the insurance policy and client funding obligation.
Assisted client with possible patient aid opportunities.
Continued following patient funding throughout the course of treatment.
Utilized tools and programs to assist in practicing sound stewardship of the organization's assets.
Provided excellent customer service and support to clients and internal staff.
Produced quarterly statistical spreadsheet reporting on referral source sites and referral volume agency wide.
Experience
7-10 Years
Level
Management
Education
AA In Paralegal Studies
Financial Case Manager Resume
Objective : Seeking a Financial Case Manager poistion with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : Budgeting, Communication Skills.
Description :
Primarily responsible for collecting co-payments and back balances from patients and checking eligibility and checking on claims status for the reason they denied.
Knowledged of billing and Microsoft Excel and merging spreadsheets to make sure services are being billed out correctly.
Made and rescheduled appointments.
Answered multi phone lines and transferring them to their appropriate departments.
Checked in patients, making sure all updated forms and documentation are added to new and existing client charts.
Printed daily appointment sheets, group schedules for the counselors and the doctor on a daily basis.
Reconciled and tracked of daily cash deposits.
Experience
2-5 Years
Level
Executive
Education
MS
Financial Case Manager Resume
Objective : Financial Case Manager is responsible for the preparation of financial reports, budgets and forecasts. Responsible for all financial aspects of a given project and are responsible to the business line manager, the project manager, and the financial controller.
Skills : Microsoft Office, Jd Edwards, Great Plains, 10 Key By Touch, Type 45 Wpm, Customer Relations, Invoicing, Accounts Payable, Accounts Receivables, Collections, Spreadsheets, Non-Profit.
Description :
Responsible for creating and maintaining 125 family budgets within the state budget grant guidelines.
Created, tracked, and processed all accounts payable for each family budget after verification.
Set up any employees working with family, and process payroll for each budget.
Created, tracked, and maintained each budget in Excel and database Submit monthly budget reports to each family and county caseworker.
In charged of accounts receivables for each budget, making sure all invoices get billed to the state of MN on a bi-weekly time frame.
Worked closely with county case workers to ensure budgets are up to date, with no unauthorized purchases.
Processed referrals and applications for patients who have lung and respiratory diseases.
Experience
2-5 Years
Level
Executive
Education
BA
Financial Case Manager Resume
Objective : To obtain a challenging Financial Case Manager position in which I can apply my experience and contribute my knowledge within the company.
Skills : Administrative Assistant, Bookkeeping.
Description :
Performed duties of licensed independent insurance adjuster for URAC accredited consulting firm.
Analyzed medical claims based on appropriateness, national billing guidelines, and reasonable and customary standards.
Conducted negotiations for settlement of claims with providers on behalf of insurance companies.
Facilitated prompt payment of outstanding accounts by acting as a liaison between patients, providers, and insurers.
Managed protected health information within patient medical records while adhering to HIPAA guidelines.
Performed follow-up calls regarding financial applications submitted.
Determined eligibility based on income guidelines, and follow-up with income changes.
Experience
2-5 Years
Level
Executive
Education
GED
Financial Case Manager Resume
Headline : Master's degree with successful experience in technical writing and federal government business development - Actively holds DoD security clearance - SECRET - Proficient with SharePoint, Microsoft Excel, Word, Power Point - Excellent communication (verbal and writing), organizational, and time-management skills with strong attention to detail.
Skills : Administrative Assistant, Bookkeeping.
Description :
Made sure extra intake charts with admission paperwork are available when needed for initial evaluation appointments.
Served as contact and resource for financial issues for the patient and/or their representative during the patient's stay/care.
Researched and verified all insurance benefits assigned to health system.
Tracked patients' status as it relates to third party coverage and keep treatment team apprised of status.
Exercised full compliance with the Agencys Code of Conduct, all Agency Policies and Procedures.
Maintained confidentiality and security for all client and staff related materials and/or records.
Assisted clients with out of pocket financial hardship apply for payment arrangements, sliding scale fees, to also ensure collection of copay/co-insurance payments, review monthly client invoices, and monitor accounts flagged for collections.
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