Financial Counselor

7 days ago

Santa Fe, United States La Familia Medical Center Full time

Position Function Summary

Under the direction of the Chief Administrative Officer, the Financial Counselor (FC) delivers general education, outreach and in-person enrollment for Medicaid and assists all patients through the healthcare system by acting as a patient advocate.

Essential Responsibilities

  • Fulfills the Federal and State contracts as required;
  • Provides general education about expanded Medicaid and enrolls patients when necessary;
  • Provides education about the New Mexico Health Insurance Exchange (the Exchange) and enrolls patients as needed;
  • Assists all patients through the healthcare system by acting as a patient advocate;
  • Reviews patient's account before scheduled appointment to ensure accuracy of account. Notes missing information to be collected at check-in;
  • Verifies insurance eligibility upon appointments being made;
  • Supports efforts to comply with CMS requirements to provide Good Faith Estimate's (GFE) to appropriate patients;
  • Counsels patients who are unable to pay for their visit and arranges a payment agreement plan suitable for the patient and organization;
  • Determines patients' financial status and makes arrangements for financial assistance programs when patient qualifies;
  • Obtains required and necessary information by interviewing applicants, family members, and others, completes applications and confirms information for accuracy;
  • Determines eligibility by applying regulations and guidelines to information provided in application documents; verifies client's continued eligibility by reviewing and verifying updated information in client's file;
  • Obtains approval of application by submitting determination for review and following up as required for finalization;
  • Educates program applicants/clients by explaining program requirements, options, interpretations, and determinations, follows-up with patient during the approval process;
  • Assists in maintenance of appropriate patient records for continuity of care, treatment planning, and patient tracking; prepares and submits all required patient and activity reports accurately and in a timely manner;
  • Verifies and assures all preliminary information has been received and all accounts are ready for billing with adequate supporting documentation;
  • Contributes to team effort by following policies and procedures; participating in quality reviews; reporting needed changes; and by accomplishing related results as needed;
  • Participates in data gathering for financial reporting;
  • Works closely with Billing Department to assure clean claim submission;
  • Performs all essential duties and responsibilities of a PSR when needed.
  • Performs all essential duties and responsibilities of an Operator when needed.
  • Performs other duties as assigned.
Requirements

Education, Experience and Skills/Training
  • High school diploma or equivalent required. A minimum of two years' experience in medical/dental operations in the areas of patient reception, patient registration, patient cashiering, and patient referrals. Must possess sufficient prior work experience in progressively more responsible positions during which the skills and abilities to perform all the essential functions have been ably demonstrated at a consistently competent level.
  • Fluent in both English and Spanish, required.

La Familia Medical Center offers a comparable benefits package.

Bargaining Unit Position

Union:

Non-Union: X

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