Patient Financial Services Specialist

The Lindner Center of Hope is a nonprofit, comprehensive mental health center and global leader offering state-of-the-science diagnosis and treatment of the most pervasive mental illnesses of our time. One of the first centers designed as a fully integrated system of care to address deficiencies in mental health care as identified by the Institute of Medicine. Innovative residential assessment, inpatient and outpatient programs in partnership with UC Health serving more than 54,660 patients from around the world. A leader in research and collaborations that are advancing the field and positioning Cincinnati as a national leader in mental health care. We embrace the many talents, skills, and experiences our employees bring to Lindner Center of Hope. Everyone is encouraged to use their unique gifts to express ideas, make meaningful contributions to our programs and genuine connections with patients and family, as well as strengthen donor, referrer and community relations. At Lindner Center of Hope, you’ll have the opportunity for a consistently rewarding career, working for an organization that shares your desire and ability to make a demonstrable difference in the lives of people living with mental illness. Position Summary: The Financial Counselor serves as the primary contact for patients and families regarding financial assistance, insurance coverage, authorizations and preservice payment. Major Duties and Responsibilities: This position is responsible for conducting financial interviews with inpatients, residential patients, and any outpatients. The Financial Counselor works with health insurance providers to determine coverage and benefit levels and provides information regarding hospital payment options and financial assistance programs. Completes necessary forms in accordance with hospital policies. Meets with patients admitted during the business day to complete the formal admission into the EMR system by collecting and verifying patient demographic and insurance information. Will also take the patient’s picture and save the image in the EMR system to be used on the patient face sheet and wristband as dictated by department protocol. Obtains the appropriate signatures on consents and assignment of benefits. Scans insurance cards, picture ID, and other appropriate documents into the document imaging system. If patient presents with new insurance, assists with insurance eligibility and benefits verification electronically. Contacts the patient or responsible party by phone to complete pre-registration and obtain or verify all demographic and insurance information making updates or corrections in the patient account system as appropriate. Screens for medical necessity and completes the Medicare Secondary Payer Questionnaire for all Medicare patients during the pre-registration process. Calls applicable insurance companies to obtain facility and professional mental health, substance abuse and eating disorder benefits. Accurately documents insurance benefits and patient’s financial liability in the appropriate fields of the patient account system. Alerts team members to any insurance coverage issues immediately. Follows up with patient/patient representative until resolved. When loading benefits, performs audit of accounts to ensure all of the required demographic, insurance, financial forms, and contracts are obtained and documented in the electronic medical record. Communicates applicable deductible, co-pay, or coinsurance to patient during pre-registration or upon check-in. Collects co-pay, deductible or other out-of‑pocket liability including residential self‑payments. Accurately posts the payment to the patient account system and receipts the patient Sets payment arrangements as appropriate. Refers the patient to the financial counselor as need arises. Review the process for filing insurance claims for inpatient, residential, PHP, ECT, TMS, IOP, and Outpatient as needed. Assess the patient’s need for financial assistance during the admission process or at a time prior to the patient’s discharge. Determines patient eligibility for Charity care for inpatient/outpatient levels of care. Completes reviews of the charity application in accordance with the LCOH charity care policies. Obtains the final approval of the application from the Registration Manager prior to notification to the patient or family. Determines when renewal of charity applications need completed. Sends letter to patient notifying them of eligibility for charity care and charity amount. Provides education / counseling to self‑pay patients regarding available government coverage options. Monitor financial counseling workqueues in EPIC for currency. Serve as the initial contact for determining out of network benefits and obtaining information for potential single case agreements or reimbursement. Work with Intake staff and other clinical teams on initial referrals to inpatient or other LCOH programs to confirm coverage levels prior to admission Work with the CFAO to determine feasibility of single case agreements Meets with the Utilization Review team routinely to discuss admissions that are a financial risk to the center. Coordinates with Intake and OPP staff to obtain appropriate authorizations, as evidenced by lack of denials for no authorization. Accurately enters authorization number(s), and authorized dates and services in the appropriate field of the patient account system. Communicates any applicable deductible, co‑pay, or coinsurance to patient prior to their visit, making arrangements for payment as appropriate. Works closely with clinical team and insurance companies to get treatment plans completed and to obtain the clinical information needed for insurance authorizations for ECT, TMS and Outpatient services. Tracks services received and follow‑up with the insurance company to obtain additional authorization as needed. In connection with the registration manager, work with Intake/ARC, outpatient registration, residential admissions and utilization review departments to ensure benefit verifications authorizations, helping hands applications, probono, financial assistance applications and other insurance related questions both internally and externally are addressed timely. Completes a note in the system on all discussions, events and outcomes regarding patient accounts. Responds to all inquiries regarding patient accounts, financial assistance policy and network status. Maintains a working knowledge of the various LCOH and LCOHPA service lines. Stays abreast of third‑party payer requirements. Attends seminars and courses on relevant topics as directed by management. This position works closely with Intake outpatient, Central Registration, Medical Records, Social Services, Utilization Review and Billing on a daily basis. Maintains effective communication and cooperative working relationships with other departments, staff, medical staff, patients, and visitors. Patient communication is conducted in a manner that will result in positive patient relations and prompt payment for Lindner Center of HOPE. Demonstrates poise and compassion when handling patient financial situations and consider all possibilities to provide the patient with the most appropriate options for their situation. Completes productivity requirements timely and accurately Assists the ECT, TMS, Financial Counselor and Welcome Center Registration Specialists with registration duties during busy times. Performs all other duties as assigned. Position Qualifications: Minimum of 3 years’ experience in healthcare required. Experience working in mental health setting preferred. Must have experience conducting face to face interviews with Collections and/or Medical Billing experience. Must have a working knowledge of third‑party payer contract terms and the ability to calculate patient liabilities. Excellent communication, customer service and math skills along with a high degree of confidentiality are required. Must have strong computer skills including Excel and Word. Analytical and decision‑making skills with a strong attention to detail required Ability to enthusiastically follow and model the Lindner Center of HOPE mission, vision and values. Physical Requirements: The physical demands of this position are consistent with those performed in a normal office environment, including occasional lifting, carrying, pushing or pulling, and sufficient manual dexterity to operate standard office equipment and ability to use to use a computer. Must be able to easily move throughout the building. All candidates extended conditional offer of employment will be subject to a WebCheck (BCI & FBI Fingerprinting). Fingerprints will be submitted to the Bureau of Criminal Investigation (BCI) and the Federal Bureau of Investigation (FBI). The reports from these agencies will include criminal record information. Lindner Center of Hope will follow the requirements for employment based on theState of Ohio Administrative Code 5122-30-31, and any other regulatory requirements regarding criminal background checks. Lindner Center of HOPE also reserves the right to obtain Consumer Reports and/or Investigative Consumer Reports as defined in the Federal Fair Credit Reporting ACT (FCRA). Lindner Center of Hope is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Lindner Center of HOPE