Under the direction of the Patient Access Manager, Financial Counselors are responsible for securing payment solutions for uninsured and underinsured patients to enable them to meet their financial obligations. Ensures the integrity of all data collected prior to or at the time of service to ensure accurate benefits information and personally collects and facilitates the accurate and timely payment for services provided by leveraging available insurance solutions. Delivers superior internal and external customer service.
Essential Functions:
- Interview patients in person and on the telephone in a professional manner that results in positive patient relations and prompt reimbursement for the hospital. Provide guidance, direction, and assistance to patients.
- Interviews patients to determine eligibility for government assistance programs.
- Assists patients with the completion of applications for state and federal programs.
- Gathers documentation required for financial assistance applications.
- Maintains ongoing communication with government agencies regarding the status of claims, following up with patients as necessary to obtain required documentation to ensure that the state gets the info needed to process the applications in a timely manner.
- Provides updates and acts as a resource to hospital personnel including Patient Access, Case Management, and Social Services on financial matters as needed.
- Screens all self-pay patients, identifies solution(s), and facilitates patient payment and/or solution application process.
- Follows up and obtains all documentation required for application processing and accurately enters information into hospital and external systems as appropriate.
- Establishes schedule for "walk-in" insurance assistance applicants and facilitates application process for same.
- Fields patient billing inquiries and refers to appropriate PFS staff for resolution.
- Monitors, manages, and actively follows up on active large self-pay and long length of stay accounts to ensure solutions/solution modifications in place for patients and optimize ultimate payment for the hospital.
- Interviews patients at bedside as needed to facilitate timely and effective payments and/or complete insurance solution application process.
- Identifies current and prior patient responsible balances, educates patients on their financial responsibilities, and collects self-pay pre-services such as Cosmetic.
- Provides estimate of charges to customers such as patients and/or offices.
- Delivers exemplary customer service for patients in accordance with hospital expectations/guidelines.
- Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
- Under supervision of mentor collects co-payments, deductibles, co-insurance, and other patient balances where applicable.
- Under supervision of mentor accepts payment, releases change, and provides receipt with 100% accuracy as indicated by daily balancing.
- Under supervision of mentor secures cash drawer according to departmental procedures with random quarterly balance checks 100% of the time.
- Under supervision of mentor completes cashier functions for facility, patient inquiries, and patient balances. Prepares daily cash receipts and processes all petty cash requests.
Education:
Associate degree preferred. High School Diploma or equivalent required.
Experience:
2-3 years in hospital registration/billing office/clinic with a current working knowledge of registration, insurance, and billing requirements. Epic experience preferred.
Knowledge and Skills:
- Maintains working knowledge of private, public, and third-party payer insurance and related regulations.
- Proficient in department collection practices and concepts of third party, bad debt, and free care regulations.
- Demonstrated knowledge of federal and state Medical Assistance eligibility regulations and advanced knowledge of healthcare finance.
- Achieve and maintain certification designation as “Certified Application Counselor.”
- Knowledge of federal and state financial assistance programs.
- Time management skills and attention to detail.
- Adhere to all hospital and departmental policies and procedures.
Newton-Wellesley Hospital will provide equal employment opportunities to all applicants and employees without regard to race, color, religion, gender age, national origin, disability, marital status, genetic information, veteran or active military status, gender identity or expression, or sexual orientation.
Primary Location
MA-Newton-NWH Main Campus
Work Locations
NWH Main Campus
2014 Washington Street
Newton 02462
Job
Finance/Accounting
Organization
Newton-Wellesley Hospital (NWH)
Schedule
Full-time
Standard Hours 40
Shift
Day Job
Posted Shift Description: Full-Time Patient Financial Counselor Monday-Friday 8:00-4:30pm
#J-18808-Ljbffr
