Patient Financial Advisor

1 week ago

Grants, New Mexico, United States Cibola General Hospital Full time
Job Overview

POSITION SUMMARY:

Under the supervision of the Patient Financial Services Director, the Financial Counselor plays a crucial role in ensuring patients have a seamless financial experience. This position involves guiding patients through the complexities of insurance benefits and potential financial responsibilities. Acting as the primary contact for financial inquiries, the Financial Counselor is responsible for collecting payments, establishing payment plans, generating cost estimates, and advising patients on their insurance coverage both in person and via phone. Additionally, the role includes evaluating patient referrals for suitability and assisting patients in understanding their options for managing significant medical expenses.

KEY RESPONSIBILITIES:

  1. Serve as the main contact for all inquiries related to financial assistance.
  2. Engage with patients to gather and comprehend their financial, social, and medical backgrounds.
  3. Collect all necessary information to process financial assistance applications, collaborating with healthcare providers on treatment plans and related medical opinions.
  4. Document all interactions and follow-ups in the electronic medical record (EMR) system, providing written confirmations to patients regarding payment arrangements.
  5. Evaluate patients' financial situations by verifying insurance benefits, acting as the expert in confirming coverage and reimbursement details.
  6. Assess patients' ability to pay and clarify insurance benefits and coverage.
  7. Initiate financial screening processes to determine eligibility for assistance programs.
  8. Assist patients in completing financial documentation and gathering supporting materials.
  9. Complete referral processes for patients facing financial challenges.
  10. Determine eligibility for care by assessing patients for various assistance programs.
  11. Offer payment alternatives, including prepayment options for elective procedures and applying for financial assistance programs.
  12. Identify suitable financial programs and assist in completing necessary documentation for federal, state, or hospital-specific assistance programs.
  13. Work with providers to assess the urgency of care for patients with significant financial liabilities.
  14. Communicate the hospital's payment policies to patients when assistance programs are unavailable.
  15. Calculate and explain patient liabilities prior to or at the time of service.
  16. Counsel patients on out-of-pocket expenses, collecting deductibles and outstanding balances while adhering to established collection protocols.
  17. If acceptable payment arrangements cannot be established for elective procedures, notify the provider and patient regarding rescheduling or cancellation.
  18. Communicate financial coverage status and decisions with all relevant parties, including patients, families, and healthcare providers.
  19. Assist in managing self-pay accounts, initiating collection procedures when necessary, and sending status updates to patients.
  20. Pursue educational opportunities to stay informed about changes in the healthcare sector.
  21. Foster effective working relationships and collaborate as part of a team to achieve departmental goals.
  22. Demonstrate respect and consideration for the dignity of all patients, families, visitors, and colleagues to maintain a professional environment.
  23. Participate in community engagement activities and clinic events as required.
  24. Perform additional duties as assigned.

EDUCATION AND EXPERIENCE:

  1. High School Diploma or GED required.
  2. Associate degree preferred.
  3. Two years of experience in healthcare revenue cycle preferred.
  4. Experience in delivering high-quality customer service.
  5. Excellent organizational and time management skills, along with strong oral and written communication abilities.
  6. Team-oriented with the ability to learn quickly and build lasting relationships.
  7. Proficient in computer skills.
  8. High level of accuracy and attention to detail, with the ability to manage competing priorities effectively.

KNOWLEDGE, SKILLS, AND ABILITIES:

  1. Understanding of medical billing and collection practices.
  2. Familiarity with computer software applications.
  3. Knowledge of business office procedures.
  4. Basic understanding of medical coding and third-party operating procedures.
  5. Ability to operate a computer and standard office equipment.
  6. Skill in providing pleasant and helpful telephone support.
  7. Ability to comprehend and follow both oral and written instructions.
  8. Capability to establish and maintain effective working relationships with patients and colleagues.
  9. Strong organizational and detail-oriented skills.

ADDITIONAL QUALIFICATIONS:

  1. Bilingual skills (Spanish/English) preferred.

REPORTING RELATIONSHIPS:

  1. Reports to the Patient Financial Services Supervisor.

PHYSICAL REQUIREMENTS:

  1. Ability to sit, stand, walk, or view a computer screen for extended periods.
  2. Ability to perform repetitive hand and wrist motions for prolonged durations.

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