Financial Counselor

General Position Summary:

The Financial Counselor is responsible to provide patients with a positive financial experience by aiding in navigating and understanding insurance benefits and potential financial liability. The Financial Counselor collects and posts payments and deposits all monies collected, establishes short term payment arrangements, creates out of pocket liability estimates, advises patients of their insurance policy benefits and coverage and financial obligations. The Financial Counselor is the patient’s point of contact for billing questions. The Financial Counselor will assist patients with eligibility for government programs and other options for managing their medical liabilities. The Financial Counselor assists patients with applying for Tennessee State Medicaid and financial assistance through Henderson County Community Hospital. The Financial Counselor reviews all financial assistance applications for determination, advises the patient of the determination, and applies applicable adjustments to the patient’s account(s). The Financial Counselor reviews self-pay accounts, determines if the patient has active coverage not identified during the registration process and works with patients to resolve financial liabilities. The Financial Counselor will apply the determined self-pay discount to patient accounts as appropriate. The Financial Counselor acts a resource to registrars with insurance, eligibility, and other questions to ensure accurate completion of demographic and insurance information for service encounters.

Duties and Responsibilities:

• Serves as the point of contact for all financial assistance related questions.
• Communicates with patients to identify and understand financial, social, and other relevant patient information.
• Gather all relevant information required to process financial assistance requests.
• Assess the current financial situation of patients through verification of patient insurance benefits, serving as the technical expert in confirming benefit coverage and hospital reimbursement.
• Conducts financial screening by reviewing submitted financial assistance applications and supporting documentation to determine eligibility for financial assistance and/or other coverage options.
• Assess and offer payment alternatives which may include pre-payment for elective care, applying for the hospital’s financial assistance program, or other available coverage options.
• Assist patient in completing application for eligible programs and in completing any required documentation for acceptance.
• Assist in obtaining exceptions to the out of network determinations from insurance carriers, escalate as necessary.
• With provider involvement, determine urgency of scheduled care for patients with large financial liabilities resulting in the decision to proceed or to defer.
• Explain HCCH’s payment policy to assist patients if determined ineligible for coverage options.
• Counsel patients on out-of-pocket liabilities.
• Complete cost estimation for services upon request. Communicate estimated liability amount to requestor.
• Collect patient out of pocket liability amounts including deductible, co-payments, open patient balances on accounts not settled.
• Works with patients on establishing appropriate short term payment plans.
• If unable to establish acceptable payment arrangements for elective procedures, inform provider and patient that services will be deferred until payment arrangements are secured.
• Works self-pay accounts by contacting patients post service to screen for coverage options, establish payment schedule, or other appropriate arrangement.
• Provides patient financial counseling services to uninsured and underinsured patients prior to, at time of, or post service.
• Enters clear documentation of all patient financial counseling activities into the patient account notes.
• Communicates coverage information to all relevant parties such as case management and patient financial services.
• Obtains signatures from patients or their legal representative if incomplete at time of admission to the hospital.
• Consults with supervisor as needed to resolve account issues.
• Adheres to hospital policy regarding patient rights including right to privacy and confidentiality.
• Reviews patient account detail for accuracy according to established department key performance indicators.
• Maintains a professional image and demonstrates service excellence with every encounter.

Knowledge, Skills, and Abilities:

• Good oral and written communication skills.
• Demonstrates age specific competency.
• Demonstrates understanding of Medicare and third-party payer coordination of benefits policies and procedures related to the admission and registration function.
• Demonstrates cash management skills.
• Ability to interact professionally, courteously, and efficiently with the public, coworkers, and payor contacts.
• Demonstrates good judgmental and the ability to make decisions effectively.
• Ability to interact with patients calmly and treat them with dignity and respect, even in stressful conditions.
• Ability to perform registration routines in the hospital’s health information system accurately and timely.
• Knowledge of HIPAA regulations and demonstrates the ability to keep protected health information confidential.

• Good time management and organizational skills.
• Proficient in Microsoft Office applications.
• Knowledge of medical terminology.
• Knowledge of revenue cycle policies and procedures.
• Knowledge of payer contracts.
• Knowledge of health insurance payors.

Work Experience, Education, and Certifications:

• High School graduate or equivalent.
• Must have at least two years of experience in the revenue cycle process.

Physical Requirements / Demands:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 pounds.

Essential or Non-Essential Classification:

• This position is designated as a non-essential position and therefore the employee’s presence at work during an emergency or bad weather conditions is not required to meet operational needs.

Statement of Non-Inclusivity:

This job description has been designed to describe the general nature and level of work being performed by the employee within this classification. It is not designed to contain or be interpreted as a comprehensive list of all duties, skills, responsibilities, and qualifications which may be required of or given to any employee assigned to the position. The skills, duties, requirements, and responsibilities outlined in this job description may be changed or added to when deemed appropriate and necessary by the company or the person who is designated to be managerially responsible for this position. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind. Employment with the company is an at-will relationship.