Financial Counselor Diffs

Responsibilities

• Greets visitors and patients upon entering the hospital in a caring and respectful manner.
• Introduces self to patients and families and lets them know he/she will be handling their financial matters.
• Promotes and maintains cooperation and communication with other hospital departments, physician offices, patients, and insurance companies.
• Courteously handles telephone calls and faxes from above areas and assists these areas appropriately.
• Serves as support to patients and their family members to assure customers have access to all available funding, which involves working with private as well as governmental agencies.
• Serves as billing office customer service support in assisting patients/guarantors and employees with billing inquiries; to include payer benefits, EOB review, collections and establishing payment plans inhouse or vendor referral.
• Affords assistance with Medicaid and Financial Assistance application forms, along with obtaining insurance coverage via Healthcare.gov.
• Facilitates the collection of patient payment for services rendered.
• Verifies insurance eligibility, if any.
• Informs the patient of hospital policies and procedures regarding the financial responsibility of the patient.
• Establishes payment arrangements according to departmental policy and obtains signature on Financial Agreement Form.
• Collections patient’s payment and documents the payment in the patient's record.
• Screens patients who present as self-pay to determine if patient has active insurance coverage prior to initiating interview for financial assistance and other governmental programs, based on internal program guidelines or state and federal payer regulations.
• Performs follow up activities relating to pending Medicaid and/or financial assistance, including follow up calls and letters to the patient and status inquiries to the Division of Medicaid.
• Maintains daily contact with Utilization Management, Business Office, Patient Registration, Medical Records, Ancillary departments, physician offices, and other outside entities.
• Makes sure appropriate turnaround on all accounts to ensure determinations are made and notification provided to the patients within established timeframes.
• Sends daily cash receipts timely and accurately.
• Reads and understands Explanations of Benefits.
• Follows up on calls from patient inquiry within 24 hours.
• Reviews patient's account history for any outstanding balances due and discusses payment options with the patient.
• Maintains accountability and control of accounts to assure that reimbursement is received and there is no financial loss due to errors.
• Maintains knowledge of payer contract terms and enforces/applies the knowledge when calculating patient's financial responsibility.
• Demonstrates good decision-making skills, reflecting a balance between mission and financial obligations.

Qualifications

• High School Diploma or Equivalent
• 2 years healthcare experience, preferably in Access Services or Business Office