Financial Counselor

Financial Counselor

The Emergency Department Financial Counselors primary responsibility is to ensure that all Emergency Department visits are reimbursable. Has good sound business judgment for establishing payment arrangements and is resourceful in exploring all avenues for payment sources. Is familiar with all Federal and State government programs for uninsured patients, Medicare, Medi-cal, Manage Care, Commercial, PPO, EPO and HMO benefits and limitations.

Major Responsibilities

• Responsible for conducting a financial screening and interview with the patient and/or family, after the Medical Assessment has been done.
• Responsible for Insurance Verification for all Emergency Department accounts. Ensures that all insurance eligibility and benefits are verified, and patient is aware of all liability. Deductible, Co-insurance, Copays and No Surprise Billing are documented in Paragon and explained to the patient prior to discharge.
• Responsible for obtaining insurance authorization from Insurance Companies and/or Managed Care providers; obtains the necessary authorization, tracking and/or reference numbers to certify the hospital Emergency Admission to Inpatient/BHU.
• Facilitates and assists with determining Medi-cal eligibility. Prescreens patient for possible Medi-cal linkage. Refers patient to RISARC and the Inpatient Financial Counselor for Medi-cal appointments.
• Facilitates and assists with determining Charity eligibility and applications.
• Facilitates and assists with Cash Flat Rates for Emergency Room & Inpatients.
• Facilitates Monthly Payment Plans for self-pay contracts, deductibles and or co-payments
• Maintains accurate and complete patient registration logs for the Admitting Department.
• Responsible for training and development of Registration staff to obtain accurate and timely financial/demographic information on all patients.
• Promptly reports all mal-functioning equipment to support services.
• Performs daily audits of Emergency Department accounts, checks all accounts for accuracy, eligibility, and completion.
• Interfaces with physicians, staff and community in a professional manner to ensure quality of service and promote patient/guest relations. Develop and maintain good working relationships with staff of physician offices.
• Interprets and explains State, Federal and Hospital policies to patients/ family in a way that they can understand and feel respected.
• Willing to assist coworkers and peers in order to improve department or organizational process.
• Flexible with shifts as emergencies arise, able to work overtime when required.

Qualifications

• At least 2-3 years of experience in Financial Counseling in a hospital setting is preferred. Working knowledge of insurance reimbursement, Medicare, Medi-cal, HMO, PPO and third party is essential.
• Familiar with Hospital Patient Registration policies and procedures, previous experience desired.
• Knowledge of Medical Terminology
• Employees must obtain his/her AVIP (Advanced Violence Intervention & Prevention) and or Fire Card course within first 60 days of employment.
• Employees are required to attend and AIDET Training class.
• Bilingual in English and Spanish is preferred but not required.

Physical Demand Analysis

Physical Requirements:

Ability to negotiate physical environment with safety

Visual Requirements:

Ability to translate and understand written communications and negotiate physical environment with safety.

Hearing Requirements:

Ability to understand and translate auditory communications with safety

Working Conditions:

Office working conditions: Normal.

Patient Care Areas: With safety precautions