Financial Counselor - Patient Access

Description

The work location for this position is Lewiston, Idaho

Full-Time: 80-hrs per pay period

Hours: 8:00am - 5:00pm

Benefits May Include:

• Medical, Dental, Vision
• 401k w/ employer match
• Short & Long-term disabilities
• Life & AD&D insurances
• Employee Assistance Program
• Pet Insurance
• and more…
  
  

Position Summary:

The Patient Financial Counselor is responsible for assisting patients and families to access financial resources. Responsible for insurance and eligibility verifications and assessment of financial requirements of recommended treatments. The Advocate counsels the patient on insurance benefits and co-payments and obtains pre-authorization when applicable. This position works closely with patients, physicians, social services, nursing staff, billing department, scheduling, and insurance companies.

Primary (Essential) Duties:

• Provide intentional and compassionate customer service. Engage in calming and confident interactions to ease patient/customer anxiety and reassure them we are here to help. Work collaboratively with patients/visitors, other departments and team members to optimize the patient experience and support efficient & effective business operations.
• Perform job functions within applicable state & federal guidelines (e.g. EMTALA, Idaho Patient Act, No Surprises Act, etc.), insurance contractual obligations, and in accordance with organizational policies and procedures.
• Maintain knowledge of current federal poverty guidelines https://www.healthcare.gov/glossary/federal-poverty-level-fpl/ and apply that information when processing financial assistance applications, and in accordance with Financial Assistance Policy.
• Maintain a working knowledge of current Medicaid eligibility requirements and options available through the Marketplace to purchase healthcare plans at a discounted rate (i.e. Your Health Idaho https://www.yourhealthidaho.org/ ). Have updated information readily available to share with patients when appropriate and applicable to their situation.
• Adhere to organizational policies and procedures regarding financial assistance. Financial Counselors are the subject matter experts and must maintain advanced knowledge and understanding of our financial assistance policy and be aware of regulatory requirements and changes.
• Meet with patients & their representatives to screen patients and evaluate possible sources of funding to assist with medical expenses.
• Provide guidance and assistance to help patients meet necessary requirements to obtain financial assistance, including collection of necessary documents and completion/submission of applications when appropriate and in accordance with organizational policies & procedures.
• Obtain and accurately input patient information into the electronic medical record promptly to support timely access to care and accurate billing & revenue cycle operations. Always use a minimum of 2 patient identifiers to ensure accurate identification of patients in accordance with hospital policy and CMS standards.
• Ensure confidential patient financial information obtained through financial counseling & financial assistance applications is maintained and securely stored/saved and separate from the medical record (apart from the approval/denial letter).
• Monitor progress and status of financial assistance applications, Medicaid and/or other payer resources available for the patient. Take ownership and work with other team members to ensure complete processing of all requests.
• Provide prompt and excellent communication with patients, representatives, and internal departments as needed to relay status updates on approval/denial of assistance. Communicate with appropriate revenue cycle teams to ensure patient account billing is categorized correctly and updated to reflect correct payers, approval/denial of charity care, etc..
• Under the direction of the Patient Access Manager, assist in creating and updating internal policies & procedures, resources and quick references (i.e. Medicaid eligibility requirements, changes to federal poverty level guidelines, links to payer resources, contact information, workflow checklists, etc.).
• Obtain and verify insurance eligibility and/or other payer information. Ensure accurate data entry of payer information into the electronic medical record. Utilize payer websites and registration applications/systems to obtain timely and accurate information.
• Performs all duties in a manner that protects the confidentiality of patients and does not solicit or disclose any confidential information unless it is necessary in the performance of job duties.
• Coordinate, communicate, and assist in monitoring workflow in response to fluctuating patient volumes to ensure work tasks and down-time projects are completed.
• Maintain a clean, professional, and organized workspace, including electronic systems. Email & outlook calendar should be used throughout your shift and kept organized and up to date.
• Attending required meetings & training. Participate in continuous process improvement efforts for your department, share pertinent information, be open to different perspectives, and share ideas with your team.
• Complete all mandated training/education promptly and completely upon hire and as required thereafter.
• Follow department and/or applicable hospital policies related to mandatory personal protective equipment (PPE) usage (e.g. when going into a patient room to obtain registration information or assisting a patient/visitor with a known communicable disease).
• Maintain a working knowledge of St. Joseph Regional Medical Center emergency codes and your personal & department’s responsibility to support and assist in the event of an emergency or code. Provide assistance in accordance with hospital policy, your licensure, skills, and training.
• Maintain a working knowledge of St. Joseph Regional Medical Center incident command activation and be prepared to support and assist efforts in the event of an internal or external disaster situation. Provide assistance in accordance with hospital policy, your licensure, skills, and training.
• Other assigned duties that support departmental and/or organizational objectives in support of our Mission, Vision, and Values.
  
  

Scion Health considers a consistently positive, cooperative, self-motivated, courteous, and professional attitude to be an essential function of every position. While different positions have different primary areas of responsibility, everyone needs to work as a team, and we expect all employees to roll up their sleeves and pitch in as necessary to get the job done.

Employees must be able to relate to other people beyond giving and receiving instructions: (a) can get along with co-workers or peers without exhibiting behavioral extremes, (b) perform work activities requiring negotiating, instructing, supervising, persuading, or speaking with others; and (c) respond appropriately to constructive feedback from a supervisor.

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g., emergencies, changes in workload, rush jobs or technological developments) dictate.

Qualifications

Required:

• High school diploma or GED
• Minimum 1-year of relevant experience
• Ability to confidently and professionally interact with patients & customers during in-person interviews.
• Ability to follow specific workflow to maintain compliance with regulatory requirements.
• Advanced proficiency in Microsoft Outlook and Microsoft Word.
• Ability to draft professional letters and written communication.
• Advanced proficiency in navigating electronic computer systems and payer websites.
• Ability to provide excellent customer service.
• De-escalation skills and ability to problem solve with patients using empathy and listening skills.
• Ability to communicate and work effectively with the public, community partners, and co-workers.
• Ability to manage job tasks, time, and resources appropriately.
  
  

Preferred:

• Prior experience working as a financial counselor or similar role.
• Prior experience developing workflow processes that adhere to changing regulatory requirements.
• Relevant certification and/or formal training.
• Prior experience working with the general public, assisting people with diverse backgrounds to accommodate the customer and business needs.