Financial Counselor II - Chemotherapy in Santa Fe, NM

Summary:

Analyze and review of self-pay accounts to make determination for voluntary free care and work with patients, physicians, social workers and other hospital staff to direct them in applying for any assistance that may be available. Responsible for interviewing patients, providing financial counseling by estimating balances due, and offering opportunities for payment. Secure payment or contract for payment. Responsible for daily review of all pre-admits, review of all in-house patient accounts identified by registration staff as a self-pay, limited insurance benefits, and insured patients who owe deductibles/co-pays/co-insurance. Offers financial arrangements, or aids the patient, spouse, or family member by assisting with completion of Financial Assistance Application (FAA) form, if applicable. Requests deposits and establishes financial arrangements before admission, upon admission, and at discharge. Performs other job duties as requested by supervisor/manager.

Responsibilities:

Patient Accounts

• Reviews accounts verified with minimal or exhausted insurance, all in-house self- pay accounts, and in-house insured patients who owe co-pays/deductibles/co-insurance.
• Review of daily reports identifying self-pay patients
• Works with inpatient teams to identify insured and under-insured patients for collections efforts
• Initiates appropriate follow-up, investigates any additional resources, deposits, discharges and transfers.
• Visits with patient or families to make financial arrangements for payment or to determine charity care and/or Medicaid eligibility
• Assists patient with billing issues and questions about insurance coverage
• Account follow up to ensure required documentation is present; i.e. insurance cards, hospital consent forms, financial assistance forms.
• Responds to inquiries from patients’, physicians’, or physician staff regarding estimated cost of diagnostic test, surgical procedures, inpatient visit, and outpatient services.
• Maintains a file of estimated charges for inpatient, outpatient, and surgical procedures. File is updated with the most current charge information.
• Quotes deposit amount.

 Documentation Responsibilities

• Consistently and documents payment arrangements previously agreed upon before patient requires services.
• Responsible for maintaining completed and signed hospital service agreement form in designated office file
• Documents all patient inquiries and requests for financial assistance approval. Files in designated office file
• Follows up with patients to obtain supporting documentation required by Corporate Management Directives. This supporting documentation is used to substantiate patient qualification for charity care or discounted care.

Registration & Scheduling

• Obtains and accurately inputs all required data elements for scheduling and registration, including patient demographic, financial information, guarantor information, and relevant notes associated with the encounter.
• Prioritizes and completes registrations / scheduling in a consistent, courteous, professional, accurate and timely manner.
• Ensures each patient is assigned only one medical record number.
• Selects appropriate patient type based on the department and services required.
• Communicates the purpose of and obtains patient/legal guardian signatures on all necessary hospital documents. Knowledgeable of all such documents.
• Hospital care consent
• Notice of Visit
• Health Information Exchange (HIE)
• Important Message from Medicare (IMM)
• Medicare Outpatient Observation Notice (MOON)
• Financial Assistance Application
• Notice of Privacy Practices
• Patient Rights
• Documents in account notes.

Insurance Verification & Explanation of Benefits

• Verifies eligibility and obtains necessary authorizations for services rendered.
• Utilizes online tools to verify insurance benefits, run medical necessity, determine estimate for services and process upfront collections.
• Answer Medicare Secondary Payor Questionnaire.
• Demonstrates accuracy in selecting insurance plans
• Knowledge and ability to review notes on all pre-admitted accounts and discuss with customer in a courteous, professional manner
• Knowledge and ability to review and explain previous accounts
• Demonstrates contribution and achievement of collection initiatives

Customer Focus

• Effectively meets customer needs, builds productive customer relationships, and takes responsibility for customer satisfaction and loyalty.
• Greets patients in a courteous and professional manner
• Calls patients by name
• Asks patients if they may have special needs

Data Errors

• Reviews data and systems daily to ensure accuracy
• Requests additional education information when necessary

Balance Cash Drawer

• Responsible for daily reconciliation and balancing of cash deposit and reporting to treasurer.

Other duties

• Reviews data and systems daily to ensure accuracy
• Requests additional education information when necessary
• Covers cashier
• Available to register patients, verify insurance and pre-cert/authorizations/notifications

Requirements:

Education/Skills

• High School Diploma

Experience

• Three to five years Hospital Business Office or reimbursement/collections

Work Schedule:

5 Days - 8 Hours

Work Type:

Full Time