Patient Financial Counselor

Patient Financial Counselor

Duties

• Pre-screens uninsured and underinsured patients to identify potential financial assistance opportunities.
• Identifies patients who may need a Medicare Beneficiary Notices of Non Coverage or any other waiver signed acknowledging patient responsibility prior to service.
• Follows up with all patients who have not been financially cleared prior to discharge (or because their service was urgent/emergent) to help them navigate their responsibility and determine if they have a financial need.
• Provides patients with personalized estimates of their financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services.
• Aids patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs.
• Documents all payer communications and pre-service patient financial conversations, including payer decisions, collection attempts, and payment plan arrangements.
• Ensures financial assistance applications are accurately filled out and complete before sending to the application processing team for review.
• Works in conjunction with on-site state social worker or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients' eligibility.
• Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage or eligibility for financial assistance according to Beacon Health System's policy.
• Initiates collections attempt on arranged payment plans or services/fees that were discounted.
• Helps patients develop a plan to resolve their liabilities, including by setting patients up on payment plans according to the established guidelines.
• Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility.
• Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.).
• Completes daily administrative tasks as necessary, such as filing, processing paperwork, and documenting interviews with patients.
• Collects payments from patients either pre service or post service and processes them within the payment portal.
• Creates deposits for cash when needed and prepares transactions for bank pick-up.
• Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by: Completing other job-related assignments and special projects as directed.

Organizational Responsibilities

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Education And Experience

• The knowledge, skills, and abilities as indicated below are normally acquired through the successful completion of a High School Diploma.
• Previous experience in customer service or a related field is preferred.
• An advanced degree is preferred.
• General knowledge of insurance.
• Demonstrated technical knowledge of the UB04 and CMS1500 claim form and 837i/837p requirements and its use and application for third party billings.
• Demonstrated technical knowledge of government agency policies, procedures, regulations and requirements.
• Demonstrated technical knowledge of Third Party payer policies, procedures, regulations and requirements.
• Organizational skills necessary to manage and control automated and manual claim submission.
• High level of customer service and professional customer interactions.
• High level of comfort working with computers and other technology and software programs including Microsoft Office.