Financial Counselor

Job Title

Financial Counselor

Job Description

Financial Counselors as part of Patient Access Department are responsible for verifying patient's insurance coverage and, as necessary, obtaining any required pre-certifications and authorizations from the patient's insurance carrier. Financial Counselors as part of the insurance verification process will verify coverage eligibility for the appropriate date of service as well as verify anticipated services are covered under the plan or contract. Financial Counselors coordinate benefits among multiple payors and determine appropriate patient responsibility, co-payments, co-insurance and/or deductibles. Financial Counselors are responsible for conducting pre-admit telephone interviews to ensure complete and accurate demographics and insurance information is entered into the Hospital Information System and also advises patients of their financial responsibility due and payable at time of service.

Job Duties and Responsibilities

Job Duties and Responsibilities:

• Prints/reviews schedules, insurance and admissions reports from Star and EPIC to secure demographic and financial information needed to conduct financial investigations. Emergency Room Visit Payer reports are also reviewed to secure demographic and financial information needed to conduct outpatient financial investigations.
• Verifies insurance coverage and benefits via telephone, internet or fax. Documents findings in notes section of Star registration including effective date of policy, subscriber, co-pay and/or deductible. CPT codes are also noted for specific outpatient insurance verifications as well as in or out-of-work benefits.
• Conducts pre-admit telephone interview. Interviews patients/guarantor efficiently and courteously to obtain accurate information to enter into the hospital information system. Gathers data necessary to ensure timely reimbursement.
• Informs patients/guarantors of patient financial responsibility including co-payments, co-insurance and deductibles due and payable at time of service. When necessary refers patients/guarantors to Director of Patient Access to ensure appropriate self-pay payments are secured.
• Ensures patients receive appropriate insurance authorizations and/or referrals per Managed Care guidelines.
• Utilizes excellent customer service skills when interacting with patients, doctor's offices and insurance companies.
• Advises patients to arrive on date of service with insurance cards, patient ID and prescription (if needed). Also advises patients of co pay, co-insurance, deductibles, authorizations and referrals needed, if applicable.
• Is knowledgeable of MMC Financial Assistance programs
• Maintains confidentiality of patients, employees, department and hospital information including computer passwords.
• Downtime policy and procedures are followed on an as need basis during scheduled and unscheduled downtimes.
• Monitors out/inpatient reports to determine policies/procedures have been followed. Makes corrections to registrations or authorizations.
• With appropriate training, accepts additional related duties in a positive manner.

Education

High School Diploma, some college or equivalent education desirable.

Experience/Skills

Previous registration or insurance verification experience desirable. Two or more years in a health related field, preferably in insurance verification. Excellence in customer service, interview and data accumulations skills, keyboard skills @45 wpm, medical terminology preferred.

General Requirements

• Devotes attention and resources to provide the best customer service possible.
• Can rely on this employee to perform assignments as necessary.
• Utilizes all available resources to reach sound decisions.
• Assumes responsibility for problems and initiates actions to solve them.
• Works with others toward shared goals including participation in department problem-solving and improvement activities.
• Demonstrates an awareness of and respect for the cultural diversity of co-workers, patients and customers treating all people with fairness and respect.
• Complies with all MMC/CHS policies and procedures in addition to those of Corporate Compliance, HIPAA, Joint Commission and all other regulatory agencies.
• Meets attendance and punctuality guidelines.
• Fosters change initiatives to ensure continuous performance improvement and service excellence.
• Performs job functions in adherence to a culture of safety within the department and organization. Also identifies safety/risk issues and communicates these to department director.
• Promotes team work and collaboration.
• Meets annual mandatory education requirements.
• Meets hospital-required health screenings.
• Lives the spirit of MMC's Mission and demonstrates knowledge of ethical and religious directives
• Completes goals and assigned projects in a timely manner.

Posted Salary Range

USD $27.20 - USD $27.20 /Hr.

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate's qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.