Patient Financial Counselor

Job Summary

Under general supervision, assist patients, families and internal customers of Michigan Medicine with a broad range of financial activities. Includes assisting patients and families with Hospital and Professional billing and insurance concerns, pre-screening eligibility for MSupport, cash collections, establishing payment agreements, providing Hospital and Professional charge estimates, and collaborating with various billing departments, specialty clinics, hospitals, and health centers on all related billing concerns.

Works independently and efficiently to assist families. Independently prioritizes work to achieve the best financial experience for patients and families. This position provides extraordinary seamless financial services to internal and external customers. This position works remotely in a high volume call center environment.

Responsibilities*

• Provide exceptional customer service to all patients/callers by offering assistance and ensuring customer satisfaction
• Depending on assignment, answers patient calls for at least 80% of workday, effectively responds to patient inquiries via telephone encounter or through the patient portal, returns patient calls left on department voicemail, responds to patient correspondence received via mail, or works on accounts with early out vendor
• Sees walk-in and scheduled patients and their families,
• Answers inbound customer phone calls for patients requiring financial assistance and direction/education
• Works closely with inpatient staff (i.e. providers, social workers, admin managers) to resolve complex accounts and accounts sensitive in nature requiring high level of business acumen, empathy and personal integrity
• Help eligible patients and families apply for Healthy Michigan Plan, Children Special Health Care Service, Medicaid and Washtenaw Health Plan
• As a Certified Application Counselor through the Affordable Care Act, assist with private Health Insurance Marketplace applications and plan selection
• Provide charge and out-of-pocket estimates for medical procedures and episodes of care
• Ability to educate and explain to customers financial related items such as referrals, authorizations, waivers and Advanced Beneficiary Notices (ABNs)
• May serve as a liaison in the community, providing education and offering financial assistance
• Serve as the point person who links various areas of a complex health system into seamless service, coordinating communication between internal and external customers
• Investigate patient financial problems to discover root causes and possible solutions via various hospital and payer systems
• Read and interpret insurance plan benefits; explain benefits to patients, families and internal customers and interpret Michigan Medicine insurance plan participation status and explain how contract status impacts patient's/family's out-of-pocket costs
• Investigate and resolve issues with third party payers including Medicare, Medicaid, Blue Cross/Blue Shield, commercial plans, motor vehicle coverage, worker's compensation and COBRA
• Identify performance improvement opportunities across revenue cycle including registration, clinic operations, information technology, charge entry, coding, documentation, billing, etc.
• Create payment plans (within established guidelines) at the conclusion of each patient contact as appropriate
• Committed to team efforts, quality improvement and lean thinking initiatives
• Respond quickly and act professionally/appropriately in stressful situations including de-escalation
• Able to handle challenging patients and customers effectively and professionally
• Demonstrates personal integrity, enthusiasm and empathy to internal and external customers
• Takes initiative in independently and effectively resolving a variety of complex billing issues and problems
• Demonstrate and communicate patient financial advocacy

Required Qualifications*

• Graduation from high school or an equivalent combination of education and experience
• Minimum of 3-5 years medical billing and/or claims experience in healthcare setting with progressive levels of responsibility
• Demonstrated teamwork, interpersonal, communication and customer service skills
• Knowledge of medical terminology, ICD-9, CPT-4, and CDM codes
• Knowledge of C-Snap, Web Denis, CHAMPS and other payor sites
• Familiarity with Lean method of process improvement
• Extensive knowledge with clinical business operation systems
• Knowledge of 3rd party payer rules and (Medicare, Medicaid, BCBSM, commercial, MVA, worker's compensation)
• Excellent record of attendance and punctuality
• Demonstrate the highest standards in written communication, utilizing available and emerging technology and systems to maximize efficiency
• Demonstrates cultural humility in communications with others

Desired Qualifications*

• Bachelor's degree in business, healthcare administration or related field
• Prior experience in healthcare billing, insurance verification, or financial counseling
• Collections/Payment experience
• Experience providing customer service in a call center environment
• Knowledge of MiChart (Epic)
• Knowledge of University policies and procedures, especially the UMHS Standard Practice Guide
• Able to understand and resolve complex patient billing issues
• In-depth knowledge of billing systems
• Knowledge of medical terminology and coding including CPT, ICD-9/10