Current jobs related to Financial Counselor - Douglas - Coffee Regional Medical C

Coffee Regional Medical Center

Financial Counselor (FT)

POSITION SUMMARY

• Timely and accurate compilation of patient socio-demographic and insurance data at the time of service. Arranges for the efficient and orderly admission of pediatric, adolescent, adult and geriatric patients to all entry points of admission. Makes patients and families aware of hospital policies and procedures. Effectively, yet professionally, request and collect patient estimated balances, including co-payments and deductibles. Will ensure managed care requirements and pre-certification/authorization needs are met prior to patient admission. Assist with flow of data between physicians, their offices, nursing units, ancillary areas, business office services, insurance companies and patient’s while insuring patient confidentiality is not breached. The duties of this position require the exercise of courtesy and patience in speaking with patients, families, co-workers, employers, state agencies and others to maintain sound public relations. Must comply with Confidentiality guidelines in accordance to CRMC policies and procedures. Must maintain regular consistent attendance, personal appearance, punctuality and adherence to applicable health and safety guidelines.

OVERVIEW

• The evaluation is to assure individual performance, departmental goals and organizational goals are aligned. It is designed to support communication between the manager and the employee. Employee perception of their own performance is very important. To maximize the benefit of this process, both the manager and the employee participate in the evaluation process.

QUALIFICATIONS

A. Knowledge, Skills and Abilities

• Excellent customer service skills.

• Reads and understands the English language.

• Ability to think critically and analytically with little or no supervision

• Ability to work effectively in situations of high stress and conflict and communicate goals and outcomes.

• Ability to process information and prioritize

• Possesses exceptional verbal and written communication skills

• Possesses independent work habits, is self-reliant and self-directed

• Ability to learn, adapt, and change as required by the job functions

• Ability to maintain absolute confidentiality of material and information accessed and reviewed

• Basic computer literacy

• Ability to move freely, reach, bend, and complete light lifting

• Ability to use good body mechanics while performing daily job functions and ability to follow specific OSHA guidelines

• Ability to maintain attendance to meet standard job practices

B. Education

• High School Graduate of GED required.

• Vocational-tech/college preferred.

• CPAR/CFC Certification preferred.

• Must be able to efficiently master departmental competency within 45 days after employment.

C. Licensure

• CPAR and/or CFC preferred

D. Experience

• Knowledge of Third-party payers, billing requirements and reimbursement methods, 3+ years of previous hospital/medical office experience. Previous data entry/programming or office coordinator experience highly preferred. CPAR/CFC Certification preferred. Prior billing/collections or financial counseling experience preferred. Knowledge of, or coursework in; medical terminology is preferred.

E. Interpersonal skills

• Customer Service ("face to face/interacting with the public") experience required. Must maintain regular consistent attendance, personal appearance, punctuality and adherence to applicable health and safety guidelines. Effective professional communication skills. Proper written and spoken usage of the English language. Spanish bilingual highly desirable.

F. Essential technical/motor skills

• Computer experience required Microsoft Suite of Products: Word and Excel. Ability to type 40+ WPM accurately and ability to use of number keypad. Analytical and organizational skills must be above average. Basic mathematical skills required.

G. Essential physical requirements

• Sedentary: Exert up to 10 lb. of force occasionally and/or a minute amount frequently - 50-74%

• Light: Exert up to 20 lb. of force occasionally and/or up to 10 lb. of force frequently - 25-49%

• Medium: Exert 20 – 50 lb. of force occasionally and/or up to 15 lb. of force frequently - 1-24%

• Heavy: Exert 50 – 100 lb. of force occasionally and/or up to 30 lb. of force frequently - 1-24%

• Very Heavy: Exceed 100 lb. of force occasionally and/or 50 lb. frequently - 1-24%

H. Essential mental requirements

• Ability to read and comprehend simple instructions, short correspondence, and memos.Ability to write simple correspondence. Analytical and organizational skills must be above average.

I. Essential sensory requirements

• Ability to visually assess if a patient demonstrates symptoms that would require emergency treatment and care. Notify appropriate clinical staff to assess patient.

J. Other

• Hours- Must be flexible to work in different areas and locations as needed. This will include the ability to work all shifts including nights, weekends and holidays. Available to come in at short notice and maintain an on-call rotation. Expected to work 40 hours per week and overtime based on the demand and need of the department.

K. Equipment used

• HIS system, computer, fax, VOIP, phone system, headset system, speakers, billing and POS collections systems.

OTHER QUALIFICATIONS

A. Exposure to hazards (body fluid exposure level)

• Level III

B. Age of Patient Populations Served

• Neonates 1 - 30 days

• Infants 30 days - 1 year

• Children 1 - 12 years

• Adolescents 13 - 18 years

• Adults 19 - 70 years

• Geriatrics - 70+ years

JOB SPECIFIC DUTIES AND PERFORMANCE STANDARDS

• Below are those tasks, duties, and responsibilities that comprise the means of accomplishing the position’s purpose and objectives. These are critical or fundamental to the performance of the position. They are the major functions for which the person in the position is held accountable. Following are the essential functions of the position, along with the corresponding performance standards.

• Registration Duties

o Use scripting policies as an effective communication tool with customers. Greet patients in accordance with the department's script policy and procedure.

o Responsible and accountable for tasks necessary to properly identify and register into the patient processing system all patients presenting for admission.

o Ability to complete scheduling, registration, precertification, financial counseling, medical necessity checks effectively all patient types in the HIS system.

o Distribute necessary paperwork and forms to each patient registered including information on Advanced Directives, Patient Rights and Responsibilities, and Important Message from Medicare with complete and detailed explanation.

o Must keep abreast of current regulatory requirements, including all state, federal and JCAHO regulations. Keep up to date of requirements from each insurance payor (Medicare, Medicaid, Managed Care, Commercial or private payors, Tricare, etc.). Adhere to external agency regulations. Demonstrate the ability to complete meet the requirements of each payor according to their guidelines.

o Responsible for documenting all contact with patients, family, employers and third party payors.

o Insure patient flow through the registration process is professional, patient friendly and within department established time standards.

o Facilitate patient paper flow for accurate and complete medical records, financial forms and patient admission to nursing or ancillary units. Obtain authorized signatures on all required forms (Conditions of Admission, Important Message from Medicare, etc…).

o Ensure all physician orders meet current standards and policies. Obtain clarification on unclear or inappropriate orders. Determine proper patient processing according to physician orders. Appropriately enters the physician into the HIS system.

o Accurately transfer, and/or discharge, place orders, etc... for patients according to doctor's orders, and according to established policies and procedures.

o Demonstrates ability to complete status changes, upgrades, system change request according to policy and procedure.

• POS Collections

o Protect the financial standing of the hospital by appropriately determining financial responsibility. Contributes to department goals by making 100% of financial arrangements for each patient prior to services being performed.

o Review patient account history to establish acceptable payment arrangements, charity assistance or agency referral notifications. Refers accounts with bad debt history to the Patient Financial Services office or accounting representatives. Effectively calculate patient liability by reviewing patient insurance benefits. Effectively financial counsel patients for estimated patient liability.

o Collects account deposits on patient estimated balances, co-pays, co-insurance and unpaid deductibles. Meet collection goals as outlined by departmental policy and procedure.

o Initiates medically needy application for charity, catastrophic and indigent write-offs. Refers potential Medicaid patients to Medicaid Benefit Specialist for screening process.

o Review all responsible party demographics for useful collection purposes from all available sources (EX.-in-house computer systems, credit reports, outside sources).

o Completes all necessary forms (write off sheets, promissory notes, receipts, credit card reports, ABNs, etc…). Forwards to necessary departments. Initiates medical necessity check. Documents encounters in the HIS system.

o Makes deposits of money collected and receipts daily in department safe according to policy and procedure.

o Is able to explain all aspects of the billing account and procedure to a patient/guarantor.

• Accuracy , Insurance Billing and Precertification

o Maintains acceptable accuracy rate according to departmental guidelines.

o Meets with Education Coordinator weekly to discuss errors. Seeks ways to improve accuracy.

o Verify complete patient, guarantor and relative information. Makes every attempt to ensure proper patient identification using all possible means including, but not restricted to patient and guarantor social security number legal name, date of birth and address. Must adhere to Patient ID policy for identifying and updating patient information.

o Identify third party payor coverage, secures prior authorizations, referrals, notifications and precertification requirements prior to patient admission. Ensures fax notifications are complete.

o Maintains working knowledge of major third-party payer regulations and compliance issues.

o Distribute appropriate information to patients according to pay source, including to, but not restricted to Medicare, Medicaid, and Champus.

o Obtain incorrect or missing information in the insurance processor. Corrects accounts appropriately according to guidelines.

o Able to obtain and verify insurance benefits and eligibility. Methods available include patient/guarantor, insurance card or electronic means.

• Other Duties

o Follow proper chain of command for issues, complaints, etc.

o Demonstrates ability to respond appropriately to department and facility codes.

o Assist in orientation and training of new staff members. Able to help evaluate new staff member for readiness to fulfill job duties independently.

o Obtain room assignment from admissions nurse, patient care director or nursing unit according to doctor's orders.

o Escort patients to ancillary service department after the registration process is completed. Assure that each patient admitted to a bed is escorted to ancillary services and to the nursing unit in a wheelchair.

o Able to perform switchboard duties according to department policies and procedures.

o Complies with Time and Attendance according to policy and procedure. Attends to personal affairs to avoid conflicts with work. Schedules days off prior to posting of new schedule.

o Refill supplies in copier, printer, and fax machines at end of each shift.

o Perform any other task requested from Supervisor or Management in a willing and positive manner.