TITLE: Financial Counselor
DEPARTMENT: Patient Access
FLSA STATUS: Non-Exempt
Responsible for securing payment solutions for uninsured / underinsured patients to enable them to meet their financial obligations. Ensures the integrity of all data collected at time of service to ensure accurate patient identification / benefits information and personally collects and/or facilitates the accurate and timely payment for services provided by leveraging available private / public insurance solutions. Delivers superior internal and external customer service.
- Screens all self pay patients, identifies solution(s) and facilitates patient payment and/or solution application process (manual and/or electronic)
- Collects and verifies patient demographic, insurance eligibility, and financial information/responsibility and accurately documents in hospital computer system(s)
- Follows up and obtains all documentation required for application processing and accurately enters information into hospital and external systems as appropriate
- Identifies current and prior patient responsible balances, educates patients on their financial responsibilities, and collects same
- Assists patients in establishing secured installments plans when applicable
- Interviews patients bedside as needed to facilitate timely and effective payments and/or complete insurance solution application process
- Monitors, manages and actively follows up on active large self pay and long length of stay accounts ensure solutions / solution modifications in place for patients and optimize ultimate payment for the hospital.
- Establishes schedule for “walk in” insurance assistance applicants and facilitates application process for same
- Fields patient billing inquiries and refers to appropriate PFS staff for resolution
- Responsible for consistent and accurate use and execution of department SOP’s (established operating procedures) and supporting tools, software, websites
- Meets performance standards established by Patient Access leadership, including but not limited to: quality, collections, customer service, screening/solution rates, productivity)
- Keeps current with all internal and external policy and procedures that may affect reimbursement
- Works effectively with patient access peers and other hospital departments
- Delivers exemplary customer service for patients in accordance with hospital expectations / guidelines
- Performs all other duties as assigned.
REQUIRED KNOWLEDGE & SKILLS:
- Maintains working knowledge of private, public and third-party payer insurance and related regulations
- Knowledge of medical terminology
- Excellent customer service/communication skills required.
- Ability to work with a high degree of confidentiality.
- Aptitude / familiarity with the tools, systems, and technologies to enable insurance verification and facilitate insurance solutions
- Comfortable with securing solutions for uninsured patients
- Knowledge of health insurance and reimbursement/billing required
- Ability to problem solve and follow through under ambiguous circumstances
- Education: Associate’s degree preferred. High School Diploma or equivalent required.
- Experience: 2-3 years in hospital registration/billing office/clinic with a current working knowledge of registration, insurance, and billing requirements.