Financial Counselor PE

Excellent communication (verbal and written) and organizational abilities.

Must develop positive relationships with clinical staff to maximize the benefit and effectiveness of the financial counseling function (e.g., Nursing notifies Financial Counselor of when an elusive family member is visiting patient).

Must be comfortable operating in a collaborative, shared leadership environment.

Knowledge of insurance payer regulations and requirements.

Knowledge of revenue cycle components and his/her role in the ability to impact the overall process.

Work which produces very high levels of mental/visual fatigue, e.g., CRT work between 70 and 90 percent of the time, and work involving extremely close tolerances and considerable hand/eye coordination for sustained period of time. The job produces some physical demands. Typical of jobs that include regular walking, standing, stooping, bending, sitting, and some lifting of light weight objects.

Ensures patient safety by authenticating patient identity throughout all essential functions.

Meets or exceeds established customer service, productivity and quality standards in all essential functions.

Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Performs activities that relate to financial counseling for multiple patient types (Inpatient Admissions, Outpatient Observation and Bedded Outpatients, Diagnostic Outpatients, Ambulatory Surgery, Emergency Department Registrations, Series accounts, etc.). Frequent communications will occur with patients/family members/guarantors, 3rd party payers, local/governmental agencies, attorneys, employers, physicians/office staff, and contracted vendors/agencies. Internal contacts include tha Patient Accounting, Patient Access, Social Work Services, Utilization Review/Case Management, Ancillary and Nursing department staffs. Assists patients in the completion of applications for all applicable funding sources.

Performs financial counseling on uninsured and under-insured patients on a pre-service, time-of-service and post-service basis. May interview patient and/or their representative either by telephone or in-house to accurately update demographic, clinical, financial and insurance data necessary to complete the financial counseling process. Activities may occur in multiple locations, including patient access points of service, ancillary departments, patient nursing units, Emergency Department, as well as telephone. Reviews prior account notes for any information that might aid in the application/payment process, as well as documents all encounters and actions.

Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. May calculate patient liabilities; conduct credit scoring and propensity to pay modeling to determine the patient/guarantor's ability and propensity to pay for services. Provides financial education and outlines potential funding options, as appropriate. In the collection of funds, the incumbent documents payments/actions in the patient accounting system and provides the patient with a payment receipt.

Seeks appropriate funding based upon patient requirements, collecting supporting documentation (payroll stubs, tax returns, credit history, etc.), as required. Provides information and education to the patient, family member, and/or guarantor of the application/documentation process. In so doing, the incumbent will encourage patient participation in the funding process and will assist the patient in forwarding the required documentation and application to the appropriate funding agency.

Counsels patient/guarantor on patient's financial liability, third-party payer requirements and outside financial resources, including private organizations and foundations, eligibility vendor(s), Medicaid, Medicare, Champus, and/or federal disability programs, etc.

Counsels patient/guarantor of payment plan options and establishes appropriate plan.

Investigates No Fault and Workers' Compensation cases, retrieving police report and insurance information, as required.

Assists patient/guarantor in completing applications for applicable funding sources, financial statement and/or payment contract when required according to hospital policies. Analyzes such applications along with income/resident documentation to advise the patient of available options. Initiates requests for charity write-off, when appropriate.

Analyzes financial and eligibility data, and length of disability to determine potential eligibility for federal, state, and/or county programs, completing the necessary documents within the time limits specified by the appropriate government agency.

Determines and manages proper course of action for optimal reimbursement of healthcare charges (e.g., spend down eligibility, out-of-network, Cobra coverage, etc.).

Informs patient/guarantor and assists patient in application process, ensuring that adjustments are requested and completed.

Responsible for monitoring accounts in the eligibility pending financial class.

Follows-up on eligibility applications status and provides appeal assistance, as appropriate.

Works with contracted vendors/agencies to qualify applicants, reviewing each case prior to agency placement.

Provides pricing estimates and communicates pre-service patient liability based on expected charges and potential coverage, as requested.

May serve as a notary public, notarizing documents for patients, physicians and customers.

May serve as a liaison for various departments, including but not limited to:

Social Work Services in establishing Medicaid pending cases for placement in long-term care facilities or home healthcare.

Utilization Review/Case Management in obtaining funding for additional services required after discharge (durable medical equipment, home health, nursing services, etc.)

May serve as relief support, if the work schedule or work-load demands assistance to departmental personnel. May also be chosen to service as a support resource to train new employees. Cross-training in various functions is expected to assist in the smooth delivery of departmental services.

Performs cashiering functions, including payment receipt and posting, balancing and recording of bank deposits and balancing of cash drawer. Performs cash refunding, adjustments and transfers, maintains petty cash drawer and other duties to prepare patient accounts for billing prior to and following discharge in order to maximize payment from all sources, to prevent collection issues and to control bad debt. Provides customer service functions such as responding to patient inquiries, generating itemized bill, processing refunds.

Performs other duties as needed and assigned.

Additional Details:

Hours: Monday-Friday 8:00am - 4:30pm

Supports the Price Estimates Call Center