FINANCIAL COUNSELOR

The Financial Counselor is responsible for obtaining insurance benefit verification, appropriate referrals, and screens patients for any insurance or financial assistance for those in our community and/or receiving treatment at Covenant HealthCare. Financial Counselors interface with multiple customers, patients, and families as well as multiple insurance carriers, adjustors, and hospital departments. Strong communication skills and ability to make sound financial arrangements for collection required. Must be able to work well with the public and able to be tactful in often hectic, stressful face-to-face situations. Maintains patient confidentiality. Maintains a positive public image with patients, families, the hospital, and medical staff.

D emonstrates excellent customer service performance in his/her attitude consistent with the standards stated in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation.

Works closely with Michigan Department of Health and Human Services as MI Bridges Navigator assisting customers with Medicaid application and/or assistance with completing a Covenant Financial Assistance Application and maintains MI Bridges Navigator policies with MDHHS.
Assist community members with enrolling in a qualified health plan through the Federally facilitated insurance exchange as a Certified Application Counselor.
Reviews and ensures that the Eligibility for Auto Claims or Michigan Assigned Claim Plan applications are appropriate with MACP and assists with completing and submission of application documentation.
Identifies Workman's Compensation accounts by appropriately researching claims with patients, employers, Adjustors and Workman's Compensation carriers.
Obtains accurate insurance benefits to ensure the patient does not receive a bill unnecessarily by exploring all options.
Informs patient of projected cost of services and payment requirements.
Exercises good judgment in the screening of patient for payor status to set expectations for reimbursement of services.
Interviews patients for more accurate financial information whenever necessary and advises patient and/or their representative of insurance benefits and gathers, advises, and makes necessary corrections in the patient's Medical Record.
 Prepares and/or explains hospital pricing, provides a Good Faith Estimate of procedures, calculates advance payment requirements, and informs patient of acceptable payment arrangements on balance, both current and previous.
Assures accurate and timely response to patient financial inquiries.
Updates Utilization Department and provides contact information to request appropriate date of service authorizations.
Works as a resource to all units, departments, and team members to positively impact patient care, customer satisfaction and financial reimbursement.
Explains alternative medical financing; assist in completion of applications and contracts to meet patient needs while assuring maximum reimbursement.
Visits patients at bedside as needed to review eligibility to qualify for available programs and completes and verifies documentation required.
Explains and answers patient billing inquiries in easy-to-understand manner; interprets data to resolve accounts.
Ability to approach patients for collection of unpaid balances prior to an elective admission.
Completes Retroactive Application and submits with supportive documentation for medical benefits.
Completes Coordination of Benefits with supporting documentation.
Prioritizes assignments and works individually or as a team member and supports each member of the team when staffing needs arise.
Actively participates in process improvement to stream-line workflows and root cause analysis.
Works cooperatively with the Central Business Office/Patient Accounting on claims.
Assist Registration Associates regarding insurance verification issues. 
Assists Associates as necessary promoting consistency and accuracy of data.
Responsible for keeping updated on all insurance changes by attending seminars, reading Provider Bulletins.
Responsible for Cashier functions which include receipting moneys received for patients balances and Covenant HealthCare departments accurately and documented in the appropriate receipting software systems.
Balances and reconciles daily cash drawer.
Maintains appropriate cash supply by reconciling cash in and cash out (e.g., change orders).
Dispenses, replenishes, and reconciles Petty Cash requests and receipts with accounts payable.
Performs other position appropriate duties as required and assigned in a competent, professional, and courteous manner.

KNOWLEDGE/SKILLS/ABILITIES/EXPERIENCE

Knowledge of Federal, State, and Local government regulations as related to Patient Access and Billing requirements. 

Including, but not limited to, EMTALA, COBRA, HIPAA, Medicare Important Message, Red Flag rules, Advanced Beneficiary Notice, Medicare Secondary Payer, No Fault Laws, and Workers' Compensation rules and the No Surprises Act.

Knowledge of standard office equipment.

Software knowledge; including Microsoft Office Word, Excel, and Outlook.

The ability to work accurately in a fast-paced changing work environment. 

Current computer experience required. 

Computer skills: Keyboard skills (typing) to be 30wpm.

Preferred: Knowledge of Epic system; experience with hospital/facility billing and/or physician/professional billing; collection experience.

Good communications skills.

Knowledge of medical and insurance terminology.

Ability to work independently in all facets of registration, verification, collection and authorization with effective problem identification and resolution skills.

E DUCATION/EXPERIENCE

R equires an annual Certified Application Counselor Certification with the Federally Facilitated Market Place.

Preferred completion of medical terminology.

Post High School: Medical Billing/Medical Assistant Program (e.g., Ross Medical).

Preferred: Graduate of Admitting Clerk/Medical Assistant program

Preferred Proficiency in Epic Admission Discharge Transfer, Resolute HB (hospital billing) and Resolute PB (professional billing) (proficient on software within six months) Collection experience preferred.

W ORKING CONDITIONS/PHYSICAL REQUIREMENTS

Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.

Constant sitting, feeling, talking, hearing, and near vision.

Frequent standing, walking and midrange vision.

Occasional lifting, carrying, pushing, pulling, climbing, balancing, stooping, kneeling, crouching, squatting, twisting, reaching, handling, far vision, depth perception, and visual accommodation.

Occasional lifting up to 25 lbs.