Patient Financial Counselor
As the Patient Financial Counselor, you will be responsible for completing insurance verification on all new admissions assigned by the Manager or Director, and for ensuring that all assigned inpatient/outpatient visits contain complete and accurate demographic and financial information. In addition, you will also work with international payers, financial institutions, and foreign hospitals to secure financial coverage for international patients. Finally, you may be utilized as overflow coverage or during downtime situations for Patient Access Representative (also known as Admission Counselor or Patient Administrative Liaison (PAL) and is accountable for responsibilities outlined in the respective job descriptions.
The client is seeking a candidate with Health Insurance knowledge, understanding insurance benefits, EPIC experience, experience in discussing and explaining insurance benefits, collection of co-pays and deductibles. You will have a lot of contact with families over the phone, in person and at the bedside providing financial counseling services. This includes providing options for self-pay patients such as setting up payment arrangements, discussing billing concerns and explaining the hospital Charity process and process for applying for Medicaid. Additionally, it is preferred for you to have a strong knowledge of all Patient Access processes including registration and insurance verification.
- Performs insurance verification, determines primary, secondary, and tertiary payers and follows up on inpatient and outpatient accounts throughout the entire course of treatment.
- Meets with the family regarding their financial status to determine potential assistance for third party coverage in a timely and sensitive manner.Makes every effort to minimize the loss of reimbursement for both inpatient and outpatient visits by securing coverage prior to discharge (unscheduled admissions) or during the patient’s visit.
- Maximizes the efficiency and accuracy of the collection process on scheduled patients.
- Participates in the department’s process improvement program. consent, information release, advanced care directives, and other documents required by JCAHO and other regulatory bodies.
- Knowledge of how managed care plans work and the requirements for insurance coverage. This includes determining the primary payer source and understanding the requirements of admission notification, authorization, and continuing utilization review.
- Also required is comprehension of detailed payment methodology knowledge of eligibility requirements for Medicaid, Medicare, CSHCN, and the Hospital Charity program. This includes the ability to identify non-covered services, secure funding for out of pocket expenses.
- Financial Counselors work with both domestic and international insurance companies and must demonstrate a high level of professionalism to ensure collectability of all assigned patient accounts.
- Incumbents in this position must be able to handle difficult financial, clinical, and social situations.
- Required- H.S. Diploma or GED
- Preferred Bachelor’s Degree (emphasis in Business)
- Required 2 years in related experience
- Standard ADA Settings
- No Certification required, however, EPIC experience preferred, hospital registration, financial counseling and insurance verification skills/experience necessary