Financial Counselor

Major Responsibilities

• Conducts a financial screening and interview with the patient or family after the Medical Assessment.
• Verifies insurance for all Emergency Department accounts, ensuring eligibility and benefits are understood by the patient. Documents deductibles, co-insurance, copays, and no surprise billing in Paragon and explains these terms prior to discharge.
• Obtains insurance authorizations from insurance companies and managed care providers, tracking and certifying hospital admissions to inpatient/BHU.
• Assists in determining Medi-Cal eligibility, prescreens patients for Medi-Cal linkage, and refers patients to RISARC and the Inpatient Financial Counselor for Medi-Cal appointments.
• Assists in determining Charity eligibility and applications.
• Facilitates and assists with Cash Flat Rate payments for Emergency Room and Inpatients.
• Maintains accurate and complete patient registration logs for the Admitting Department.
• Trains and develops Registration staff to obtain accurate and timely financial/demographic information on all patients.
• Promptly reports malfunctions of equipment to support services.
• Daily audits Emergency Department accounts, checking for accuracy, eligibility, and completion.
• Interfaces professionally with physicians, staff, and the community to ensure quality of service and promote patient/guest relations.
• Interprets and explains State, Federal, and Hospital policies to patients/family in a way they can understand and feel respected.
• Willing to assist coworkers and peers to improve department or organizational processes.
• Flexible with shifts as emergencies arise, able to work overtime when required.

Qualifications

• At least 2-3 years of experience in Financial Counseling in a hospital setting.
• Working knowledge of insurance reimbursement, Medicare, Medi-Cal, HMO, PPO, and third-party benefits.
• Familiarity with Hospital Patient Registration policies and procedures.
• Knowledge of Medical Terminology.
• Must obtain AVIP (Advanced Violence Intervention & Prevention) and/or Fire Card course within 60 days of employment.
• Required to attend and complete AIDET Training class.
• Bilingual in English and Spanish is preferred but not required.