Financial Counselor Sun - Thurs 8 am - 4:30 pm (4670)

JOB SUMMARY


Assesses patient or responsible party's financial ability to pay for services and arranges methods of payment. Assists in identifying sources of payment and refers patient to internal or external agencies for special needs. Provides continuity from in-house/outpatient encounters to post-care to ensure that the financial requirements are carried out.

Key Job Responsibilities

Essential Function


Reviews registration/admission/census data to verify and document all demographic, insurance, and financial information. Coordinates with Admission Staff, Insurance Account Representatives, Utilization Review/Managed Care Coordinators, Physician's Offices, and Billing as required.

• Confirms general demographic information on guarantor and patient.
• Obtains prior approval or preadmission authorization.
• Verifies name, address, insurance coverage and benefits.

Interviews patients/guarantor prior during pre-admit, admission or discharge process to secure information required to discuss, evaluate and assess financial status as ability to pay for services in accordance with established policies and procedures.

• Advises patients on expenses associated with admission/visit.
• Secures payments or payment arrangements on verified accounts.
• Discusses third party coverage with patient/guarantor and arranges disposition of out of pocket balances due.
• Informs patients of payment requirements as soon as possible after admission/visit.
• Ensures that all forms required by federal, state, local, and internal entities are accurately completed and signed by patients/guarantors.

Determines payment sources or agency eligibility for appropriate referrals. Refers patients potentially eligible for third party payment through TennCare/Medicaid, Medicare, Crime Victims, Vocational Rehabilitation, etc., and carries out application/notification to appropriate entities, referring patients to other counseling sources as needed by maintaining a working knowledge of grants, funds, and other resources available for qualified accounts.


Identifies admissions that qualify for charity.

• Determines and indicates in patient notes, gross income and other financial information.
• Reviews medical records for eligible candidates for various charities.

Consistently takes part in the discharge planning process. Contacts patients/guarantors as indicated according to internal policies.

Essential Function


Answers account inquiries and communicates effectively to provide information/assistance and resolve problems. Confers and works collaboratively with patient/family/hospital staff in a customer responsive and courteous manner, in compliance with iRESPECT standards and promoting patient/customer satisfaction.


Prepares and maintains files and required records, reports for administrative and compliance purposes.


Maintains confidentiality of patient, department and hospital information. Adheres to established department and organizational policies in processing and releasing patient information (i.e. HIPAA, Confidentiality and Compliance Policies).


Completes required continuous training and education, including department specific requirements. Responds to problems/opportunities to improve work environment and participates in unit based performance improvement activities.

Physical Demands


A thorough completion of this section is needed for compliance with legal standards such as the Americans with Disabilities Act. The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

Physical Demand

N/A

Rarely

Occasionally

Frequently

Constantly

Weight


Standing

X

Walking

X

Sitting

X

Lifting

X

Carrying

X

Pushing

X

Pulling

X

Climbing

X

Balancing

X

Stooping

X

Kneeling

X

Crouching

X

Crawling

X

Reaching

X

Handling

X

Grasping

X

Feeling

X

Talking

X

Hearing

X

Repetitive Motions

X

Eye/Hand/Foot Coordination

X

Education

Education Level

Education Details


Required/ Preferred

High School Diploma


Or equivalent education/experience in social sciences, insurance, or related


Required

Work Experience

Experience

Experience Details


Required/ Preferred

Minimum 2 years experience


Patient accounting, medical office, business or related experience preferably in insurance


Required