Financial Resolution Advocate

About the role

The Financial Counselor-Cashier interprets and applies financial policies to make appropriate financial decisions and payment arrangements to ensure financial viability. Prepares and presents fee estimates to current and potential patients. Provides financial education regarding benefits to patients to assist in understanding their personal financial liability. Demonstrates the ability to assertively pursue necessary information and to function independently to secure financial resolution on accounts. This role is also responsible for the timely and accurate posting of patient payments and adjustments to the patient accounts, as well as daily cash and adjustment reconciliation with the patient account system and the accounting department for payments made at the hospital.

Responsibilities

• Interviews patients referred for financial counseling in person or via telephone to determine needs and formulate a plan for financial resolution.
• Uses CPT codes to calculate estimated procedure costs and determines patient eligibility for Medicaid, special programs, or payment arrangements based on federal, state, and hospital policy.
• Educates patients on their benefits, patient liability, and the process for applying for Medicaid, completion of financial statements, and payment alternatives.
• Informs patients of hospital and clinic billing practices/policies and their rights and responsibilities regarding payments.
• Reviews completed financial statements and determines patient qualification for payment arrangements, documenting decisions in registration/billing systems.
• Works with specialty departments to establish appropriate financial arrangements for elective services.
• Identifies and resolves potential patient account issues for WVUH and UHA billing departments.
• Resolves billing questions for patients in Inpatient, Chestnut Ridge, or Physician Office Center patient services areas.
• Monitors daily reports to identify large-dollar account balances and private-pay patients needing resolution.
• Refers patients to local, state, and/or federal agencies for assistance.
• Obtains demographic, billing, and insurance information from patients or guardians and enters it into registration/billing systems.
• Obtains and scans patient insurance/medical cards and driver’s licenses into the registration system.
• Collects deposits, copayments, deductibles, and patient liability payments when applicable; provides receipts and documents payments.
• Balances daily receipts and cash drawer for patient payments; prepares and delivers deposit bags to the cashier’s office.
• Follows up on accounts as indicated by system flags (e.g., courtesy dismissal, comments, red stickers).
• Initiates auto accident liability coverage by identifying patients involved in auto accidents and documenting relevant information.
• Initiates ERSD (end-stage renal disease) screening by identifying ESRD patients and documenting SSI coverage information.
• Initiates Veterans Administration eligibility screening by identifying VA-eligible patients and coordinating admission/treatment with AV.
• Initiates Black Lung SSI screening by identifying patients covered under Black Lung and documenting relevant information.
• Initiates Workers Compensation screening by identifying patients seeking treatment for work-related injuries and assisting with paperwork.
• Initiates MSP (Medicare Secondary Payer) screening by obtaining required information and documenting it in the registration/billing system.
• Maintains timely and accurate posting according to departmental goals and reports to management.
• Documents accounts clearly and accurately; collects patient copays and deposits according to insurance coverage regulations and organizational financial policy.
• Communicates account information to patients and maintains petty cash transactions, requesting monthly reimbursement funds.
• Completes and reconciles bank deposits daily; reviews and reconciles all postings monthly with the accounting department.
• Exercises proper stewardship through appropriate use of supplies, equipment, and time.
• Communicates and interacts professionally with clients, families, visitors, physicians, staff, and the public.

Minimum Qualifications

• High school graduate or equivalent.

Preferred Qualifications

• Two (2) years’ experience in a healthcare setting.

Skills

• Ability to accurately utilize applicable computer software and equipment for access processing.
• Reading and comprehension ability.
• Basic knowledge of medical terminology.
• Basic knowledge of time-of-service collection procedures preferred.
• Basic knowledge of ICD-9 and CPT coding preferred.
• Ability to type 25 words per minute.
• Projects a mature problem-solving attitude while dealing with interpersonal conflict, dissatisfied patients, and time demands.
• Maintains knowledge of revenue cycle operations, third-party reimbursement, local/state/federal regulations, and medical terminology.
• Uses excellent customer service, written, and oral communication skills.
• Maintains knowledge of current online banking systems and discount contract agreements.
• Strong business math and analytical skills required.
• Comprehensive knowledge of healthcare insurance remittance voucher formats and coding required.

Physical Requirements

Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling are necessary body movements utilized throughout the work shift. Must be able to sit for extended periods. Visual acuity must be within normal range. Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects. Must have manual dexterity to operate keyboards, fax machines, telephones, and other business equipment. Must meet Department of Labor’s MEDIUM duty standard (exerting up to 50 pounds of force occasionally, up to 20 pounds frequently, and up to 10 pounds constantly).

Working Environment

Office and patient care environments; may be required to travel between facilities/buildings.