Patient Financial Counselor

About the Role

Provides financial counseling either in person or via telephone for all patients for designated areas, including admissions-scheduled and/or elective, in/out surgeries, and/or outpatient clinical services. Coordinates and completes patient billing and collection functions at the time of the initial interview, prior to services being rendered, and/or after the insurance carrier has paid. Maintains a close working relationship with assigned clinical departments to ensure clear communication and handling of all patients’ financial needs while providing accurate and efficient service.

Responsibilities

• Interviews patients with inadequate or no insurance coverage to obtain suitable financial arrangements prior to services being rendered for admissions, surgeries, and outpatient clinical departments.
• Follows Revenue Management policies and procedures regarding financial matters and payment arrangements.
• Conducts detailed discussions with patients to determine eligibility for Medicaid and other federal, state, and local government or private financial assistance programs.
• Meets with patients one-on-one to discuss the price of care, their financial situation, and obtains all pertinent demographic and financial data to resolve accounts.
• Serves as an advocate to educate patients on financial matters and what to expect regarding billing and account status.
• Answers patient questions pertaining to financial, billing, and account status, taking ownership of issues to ensure timely resolution and customer satisfaction.
• Provides oversight for assigned departments and may serve as the first point of contact regarding Patient Financial Services.
• Offers back-up support and coverage for other departments, including report analysis for areas not covered by a Coordinator.
• Acts as a coordinator between Revenue Management teams, clinical departments, providers, and patients concerning financial counseling activity.
• Calculates patient’s outstanding balances and finalizes resolution methods through pre-service financial counseling, point-of-service collections, payment plans, or other arrangements.
• Performs accounts receivable review for special pricing packages, identifies areas of opportunity, and provides trending information with recommendations.
• Prepares receipts for payments collected and promotes day-of-service cash collections and outstanding balance collections system-wide.
• Assists patients by preparing pre-service price estimations, educating them on insurance benefits, and arranging payment terms.
• Conducts research and follow-up activities on assigned accounts according to established procedures and time frames.
• Assists in maintaining control of self-pay accounts receivables and resolves accounts via charity, vendor referrals, or financial status determination.
• Performs troubleshooting activities for financial advising and service issues within assigned service lines.
• Manages assigned projects and tasks associated with these efforts.
• Assists physicians, insurance companies, employers, and others with requests concerning financial clearance and patient accounts.
• Coordinates with other departments to resolve financial clearance, insurance, billing, collection, and related concerns.
• Completes and updates Electronic Medical Records for all patients interviewed, following billing systems and approved guidelines.
• Advises supervisor of unusual situations, chronic financial, medical, or legal problems.
• Ensures compliance with federal, state, and third-party billing requirements.

Work is typically performed in a clinical and office environment. Travel may be required.

Requirements

• High School Diploma or Equivalent (GED) (Required)
• Associate's Degree (Preferred)
• Minimum of 3 years of related work experience (Required)