Financial Counselor PFS - Full-Time

This Full-time Opportunity will work 80 hours bi-weekly.

Monday

• Friday, 8:00am

• 4:30pm.

Benefit Package that includes Medical/Dental/Vision insurance, Life Insurance, Short and Long Term Disability,

403B Retirement Savings Program and Paid Time Off.

Job Summary

Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.

Under general direction of the Medicaid Advocacy and SelfPay Manager, this position is responsible for counseling patients regarding insurance benefits and recommend alternate sources of payments and financial assistance to uninsured/underinsured patients and families. Assist patients with applying for Medicaid coverage and private insurance applications through the Healthcare Marketplace. The Patient Financial Counselor assists in obtaining discounted care for under income candidates and helps them resolve any current outstanding debt on existing accounts.

Example of Essential Functions:

• Project a positive and helpful demeanor while working with patients, visitors, and staff.

• Collect appropriate deposit, deductible and/or co-insurance amounts from patient/guarantor at pre-admit, admit, in house or at discharge.

• Complete insured and uninsured patient estimates upon request.

• Responsible for timely documentation of all pertinent information on the patient account.

• Evaluate guarantor financial status using credit reports, previous account information, eligibility tools, employment history, and all other income verification documentation, to determine the most feasible method of payment.

• Gather and assess financial data to help determine patient eligibility for Medicaid, SSI, charity and other financial assistance programs while working cohesively with associated vendors.

• Responsible for working daily inpatient uninsured lists timely, including but not limited to patient assistance screening.

• Responsible for evaluating, tracking, and adjusting all assigned patients for Charity.

• Handle walk-in and incoming customer service questions, including but not limited to charge explanation, relaying/explaining insurance activity, and setup of payment arrangements.

• Maintain compliance with state and federal regulations as they relate to Patient Financial Services.

• Manages accounts that have been referred to the early out vendor.

• Manages accounts needing to be transferred from the early out vendor to outside collections agencies.

• Passes and maintains certification for Market Place / CAC eligibility to be able to assist patients needing help applying for health care coverage.

• Manages accounts needing to be written off to bankruptcy.

• Functions as a liaison for the department to ensure open and effective communications between Case Managers and Patient Access.

• Processes patient correspondence, queries and disputes from our collection agencies

Required Knowledge, Skills and Abilities:

• Computer skills, will be working in multiple accounting systems. Hospital, Physician and Home Health

• Mathematical, organization skill and business correspondence skills

• Basic knowledge in downloading/creating spreadsheets in Microsoft Excel

• Proficient on 10 key, printers, telephone, copiers, and fax. Familiar with medical terminology and third party payer methodology. Demonstrates a thorough knowledge of Medical necessity and compliance laws.

• Excellent oral/written communication and professional skills in relating to patients and their families.

• Good understanding of other resources or programs available for patients and families.

• Thorough knowledge of payment policies, patient assistance policies, verification and billing processes.

• Must demonstrate ability to manage time, deadlines, multiple request and priorities, maintain productivity and exercise good judgment with minimal supervision

Minimum Education, Training, and Experience Required:

• High school diploma or GED required. Some college coursework preferred (Business/Health Sciences)
• A minimum of one year hospital/physician billing/follow-up experience is preferred.

Patient Contact

Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:

_X _Neonate (0 thru 30 days)

_XInfant (31 thru 12 months)

_XChild (13 months thru 12 years)

_X_Adolescent (13 years thru 17 years)

_X_Adult (18 years thru 65 years)

_X_Geriatric (66+ years)

Physical Demands:

Sedentary

• Light Work

• Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors:

Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.

Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.

Working Conditions:

A. Bloodborne Pathogens Exposure Risk: Category B - MAY have exposure to blood or body fluids.

Reporting Relationship:

Reports to Manager Patient Accounts