What are the responsibilities and job description for the Patient Financial Counselor position at St. Mary's Health Care System?
Employment Type
Full time
Shift
Day Shift
Description
Responsible for coordinating reimbursement sources and other activities related to securing reimbursement for medical group services provided to patients who are either received professional services or who may be seeking to obtain services. Work with patients to ensure the medical group receives maximum payment for all services rendered, while assisting the patient
with avenues of financial assistance available to them. Educates and assists patients with understanding their insurance coverage and benefits / options, setting up payment arrangements, and collecting patient financial responsibilities. Assists uninsured or underinsured families with navigation of the process related to applying for the government sponsored healthcare resources and / or Trinity’s Financial Assistance program.
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
Full time
Shift
Day Shift
Description
Responsible for coordinating reimbursement sources and other activities related to securing reimbursement for medical group services provided to patients who are either received professional services or who may be seeking to obtain services. Work with patients to ensure the medical group receives maximum payment for all services rendered, while assisting the patient
with avenues of financial assistance available to them. Educates and assists patients with understanding their insurance coverage and benefits / options, setting up payment arrangements, and collecting patient financial responsibilities. Assists uninsured or underinsured families with navigation of the process related to applying for the government sponsored healthcare resources and / or Trinity’s Financial Assistance program.
- Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
- Performs analysis of current and future patient account to validate third party coverage and to determine what if any amount is patient responsibility.
- Conducts patient financial interviews to assist with the resolution of the patient’s account, and to ensure compliance with medical group financial resolution policies.
- Assists and educates patients with respect to available resources for medical coverage including the Insurance Marketplace, governmental programs, payment programs and financial assistance. Distributes information and estimates for No Surprise Billing according to department standards.
- Provides information, education, assistance, and follow-up as needed to complete charity processing for assigned patients, as appropriate.
- Directly contacts patients and guarantors as to rights, responsibilities, and procedures with regards to payment for care.
- Collects patient payments and handles according to RHM policy.
- Performs follow-up by telephone and/or written correspondence with patients who have not completed their financial application process prior to receiving certain elective or routine procedures.
- Monitors all self-pay and Medicaid (MA) pending patients weekly to ensure active follow-up for insurance is in progress.
- Interacts and collaborates with numerous departments to resolve issues (i.e., Practice Leaders, Centralized Authorization, Legal Department, Patient Accounts) and provide necessary information that will ensure medical group reimbursement for Third Party liability.
- Communicates routinely with physician offices as needed regarding the financial status, and deposit resolution for patients seeking certain elective or routine procedures.
- Escalates unresolved financial matters and / or complaints to Supervisor/Manager in a timely manner.
- Obtains and records new personal, demographic, medical insurance information. Ensures that patient demographic and financial information is complete and accurate.
- Ensures excellence in customer service relations provided to patients, family members, coworkers, and providers.
- Other duties as needed and assigned by the Supervisor/Manager.
- Must be comfortable operating in a collaborative, shared leadership environment.
- Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Integrity and Compliance Program and Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
