Financial Counselor Lead - Patient Access - Full Time/Days - Req#2030367436

Job Objective:

Under general direction and supervision of the Patient Access Manager, or other designee makes financial arrangements for patients without insurance or with inadequate insurance coverage: collects required deposits from patients and/or guardians: assists patient in obtaining financial sponsorship from outside agencies and charitable programs when financial need is indicated. Assist in training and providing education to the staff.

Essential Duties and Responsibilities:

• Obtain authorization for acute inpatient admissions timely
• Protects the financial standing of the hospital by appropriately determining financial responsibility, arranging payments on deposit due, obtaining appropriate signatures on financial forms, and adhering to written policies and procedures of the hospital.
• Collects payments due on current accounts and maintains record of collections to report to Supervisor monthly.
• Review and assist patient’s who cannot pay according to payment schedule and/or refers clients to appropriate government programs for financial assistance.
• Furnishes and processes forms for government programs available for clients.
• Processes accounts for financial information and income verification to determine category of assistance needed, and whether the criteria are met for the category.
• Prepares and processes correspondence requesting required information to complete the patient account file.
• Screens for legal action in accordance to business office guidelines
• Contributes to department goals by making 100% of financial arrangements for each patient during Emergency or Admission stay when possible.
• Establishes proper lines of communication by introducing him/herself, calling patient by full legal name and identifying the reason for the interview or phone contact with each patient or family member.
• Completes the monthly report of collections and meets with supervisor to review.
• Shows regard for the dignity and respect of all patients, family members, visitors, and hospital personnel as defined by the hospital’s philosophies and mission statement.
• Performs other responsibilities and special projects as required/assigned to facilitate the smooth operation of the department, which may include filling in for an absent employee.
• Performs other miscellaneous duties as required.
• Assist in prioritizing workflow of the PFC’s.
• Provide reports and data of uninsured patients to management

Non-Essential Duties:

• Keying data to computer system

• Bilingual preferred

Knowledge, Skills and Abilities:

• Excellent verbal and interpersonal communication skills.
• Ability to react to changing circumstances and recognizes those requiring immediate attention.
• Ability to recognize and evaluate problems, and to develop and implement solutions.
• Ability to develop and implement new ideas/systems with innovation and creativity.
• Ability to work under pressure and meet time parameters.
Ability to learn the advanced aspects of the various information systems.

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Education and Experience

Education

• High School graduate or equivalent.

Experience

• 2 years' previous Commercial, HMO, PPO, and Workers Compensation billing and/or insurance follow-up experience, preferred.
• 2 years' experience or equivalent combination experience in prior authorization, pre-certification, insurance benefits and how they apply to hospital registration or medical office settings.
• 2 years' experience in customer service.

Required Licensure and/or Certifications:

• Medi-Cal HPE Certification (Acquire within 3-6 months of hire date)
• Medi-Cal Your Benefits Now (YBN) portal or any future online application portal. User training and completion of user agreement to be completed upon Management's determination.

Physical Requirements and Working Conditions:

• Primarily works in a climate-controlled area.
• Sitting 80% of time on duty.
• Tolerate repetitive arm and hand movements.

Education and Experience:

Education

• High School graduate or equivalent

Experience

• 2 years recent experience in an Admitting Department in an acute care setting. Will consider 2 years recent acute care hospital Business Office experience
• 2 years previous Commercial, HMO, PPO, and Workers Compensation billing and/or insurance follow-up experience, preferred