Financial Counselor

About the role

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. The Inpatient Financial Counseling Specialist performs benefit education and validation, including face‑to‑face review of inpatient benefits, authorization, and collection of patient liabilities for inpatient, observation, and outpatient in‑bed services.

Responsibilities

• Perform benefit education and validation.
• Conduct face‑to‑face review of inpatient benefits, authorization, and collection of inpatient, observation, and outpatient in‑bed liability.
• Accurately verify and calculate patient liabilities including previous balances.
• Collect patient payments.
• May require nights, weekends, and holidays as necessary.
• Perform functions while meeting Ensemble’s mission and regulatory compliance requirements.
• Work within policies and processes as they are performed across the organization.
• Assess and collect patient liabilities (copays, deductibles, co‑insurance, balances after financial assistance).
• Assess patient insurance and financial information to determine liability.
• Utilize face‑to‑face communication with patients during their stay to collect estimated patient liability.
• Work various patient access, insurance eligibility, and follow‑up reports as assigned.
• Assist in facilitating daily in‑house call reviews to validate that patients have a valid payor source with authorization on the account for the current stay.
• Complete pre‑registration and registration tasks, including registration of patients at time of service or prior to date of service while attempting to collect patient’s financial liability.
• Monitor missed collection opportunities for potential process improvements and follow‑up.
• Make at least three attempts each day to visit a patient's room if the patient is otherwise preoccupied in previous attempts.
• Note all accounts with a patient liability daily.
• Make follow‑up phone calls to patients unable to make payment while in‑house.
• Send letters to patients' addresses post‑discharge detailing an estimated liability and payment options.
• Work with patients to sign consent to treat, observation, Important Message from Medicare, and other registration‑related forms if applicable.
• Assist eligibility specialists in verification of insurance information, Medicaid and charity processing, and other tasks as needed.
• Run a daily census to determine patients with potential eligibility.
• Assist in the collection and organization of outpatient orders as they relate to future and current dates of service, utilizing queues built within various Revenue Cycle systems.

Requirements

• 1+ years of customer service experience

Qualifications