Pt Financial Counselor

 Patient Financial Counselor (PFC)  

General Summary:  

The Patient Financial Counselor coordinates activities of a fully integrated credit and collection process to ensure the maximum collection of outstanding self-pay patient balances.  He/She works in collaboration with Patient Access, Operating Room, physicians’ office staff, and SMH Business Office staff to secure timely and accurate collection of self-pay receivables while working within the established guidelines of the Charity Care/Community Care Policy.  This person must be able to work with, and keep confidential, the highly confidential and sensitive patient care and patient financial information.  The PFC must comply with all HIPAA policies, Patient Rights, Speare’s policies, and all State and Federal guidelines. 

Essential Job Functions*: 

• The PFC meets with all walk-in patients with billing questions, complaints about hospital services, and questions about charity and/or other available patient payment methods. 

• Ensures that patient inquiries are researched and resolved in a timely manner. 

• Under the direction of Self Pay Billing & Collections guidelines, approves and/or denies all extensions and levels of reimbursement of Patient Payment Plans. 

• Recommends other sources of credit such as banks, insurance companies, and credit unions in order those patients may be able to gain other credit sources. 

• Processes all self pay refund and adjustments consistent with current policies and procedures. 

• Handles placement of bad debt accounts and serves as Speare Memorial Hospital’s contact with collection agencies. 

• Works with the public as part of a CAC to help access insurance through the NH Marketplace network. 

• Financial counselor will go through the process of getting certified to enroll patients into the marketplace. 

• Ensures that the Charity Care policies of Speare Memorial Hospital are enforced and that collection activities comply with State and Federal guidelines.  Secures patient information in a timely manner that is relative to their financial status such as employment, salary, federal income tax return, references, and other financial obligations in order for review of the Charity Care application.  Processes approved Charity Care applications; sends approval/denial letters with individual family member cards.  

• Interviews self-pay inpatients, observation, and Emergency Department patients to complete the Charity Care/Community Care applications, and/or the NH Easy Medicaid application prior to patient leaving the hospital, or at the least, their business card for a future dated appointment. 

• Completes New Hampshire Health & Human Services prenatal application to ensure health care coverage for prenatal visits, delivery, and newborn. 

• Recommends other sources of payment such as New Hampshire Medicaid and various welfare agencies to acquire information regarding financial assistance available for patients unable to pay for hospital services. 

• Identifies and relays to the PFS Manager, issues or trends that could affect hospital cash flow. 

• Demonstrates independent judgment in times of need, along with the ability to seek guidance and/or support from appropriate resources. 

• Complies with hospital and departmental policies, procedures, regulations and standards as related to job. 

• Demonstrates hospital’s stated mission and values of teamwork, respect and communication with co-workers, patients, families and visitors. 

• Actively and appropriately participates in problem-solving identification and resolution, both intra- and inter-departmentally. 

• Meets department customer service standards and strives to enhance the level of customer service provided.      

Qualifications: 

• Education  

Required:  High School Graduate or GED  

Preferred:  Two years post-secondary education in accounting or business administration preferred 

• Work Experience 

Required: Prior healthcare office/hospital setting 

Preferred: Two years or more in healthcare collections or office setting with emphasis on Financial Counseling.  

• Licensure/Certifications/Registrations 

Required: none 

Preferred:  

• Other Skills/Knowledge 

Required: Excel and Word experience 

Preferred: Knowledge of Federal Income Tax Returns and their schedules. Knowledge of State and Federal laws and requirements regarding collection activities.  Comprehension of Federal Compliance and HIPAA regulations.