Financial Services Representative

1 week ago

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

Cibola General Hospital is seeking a highly skilled Financial Counselor to join our team. As a Financial Counselor, you will play a critical role in providing patients with a positive financial experience by helping them navigate and understand their insurance benefits and potential financial liability.

Key Responsibilities:

  • Serve as the point of contact for all financial assistance related questions.
  • Communicate with patients to identify and understand their financial, social, and medical histories and other relevant patient information.
  • Gather all relevant information required to process financial assistance requests, including working with providers on treatment plans, best practices, and related necessary medical opinions.
  • Document all communication and follow-up in the electronic medical record (EMR) and send written confirmation to patients regarding payment arrangements, etc., as applicable.
  • Assess the current financial situation of patients through the verification of patient insurance benefits, serving as the technical expert in confirming patients' benefit coverage and hospital reimbursement.
  • Determine the patient's financial ability to pay and explain insurance coverage and benefits to the patient.
  • Initiate the financial screening process as appropriate to evaluate eligibility for assistance programs.
  • Assist patients in completing financial statements and gathering supporting financial documentation.
  • Complete the referral pattern for patients with financial risk.
  • Determine eligibility for care at Cibola General Hospital by assessing patient eligibility for Medical Assistance, Emergency Medical Assistance, Community Programs, and Government Programs.
  • Assess and offer payment alternatives, which may include prepayment for elective care, and applying for Cibola General Hospital's financial assistance program.
  • Identify eligible financial programming options and assist in completing all necessary documentation for specific federal, state, or Cibola General Hospital financial assistance programs.
  • With provider involvement, determine the urgency of scheduled care for patients with large financial liabilities, resulting in either a decision to proceed, hold, reschedule, etc.
  • Explain Cibola General Hospital's payment policy to patients if a program is not available to assist with payment.
  • Calculate and explain any patient liability before or at the time of service.
  • Counsel patients on out-of-pocket liabilities and collect deductibles, pre-payments, and outstanding balances following established collection procedures, or alternatively, create a payment plan with the patient and document the agreement appropriately.
  • If unable to establish acceptable payment arrangements for elective procedures, inform the provider and patient that services will be rescheduled or cancelled.
  • Communicate financial coverage status and applicable financial decisions with all appropriate parties: patient, family, referring clinicians, and Cibola General Hospital clinicians.
  • Assist with the maintenance of self-pay accounts, initiate collection procedures when appropriate, and send out letters to patients regarding the status of the accounts; place accounts in the financial class needed before the account goes to collections if patients do not respond to calls and letters.
  • Pursue and participate in education opportunities to remain current with changes in the healthcare industry.
  • Promote effective working relations and work effectively as part of a team to facilitate the department's ability to meet its goals and objectives.
  • Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
  • Attend on-site/off-site community engagement activities and on-site/off-site clinic events as needed.
  • Perform other duties as assigned.
Requirements:
  • High School Diploma/GED Required
  • Associate degree preferred
  • Two years' experience in healthcare Revenue Cycle preferred
  • Experience in providing high-level customer service
  • Excellent organization and time management skills, along with excellent oral and written communication skills
  • Strong team player
  • Ability to learn quickly, build and maintain long-term relationships, and work with minimal supervision
  • Proficient computing skills
  • High level of accuracy and attention to detail, flexibility, and ability to attend to competing priorities in an effective and timely way, and prioritize effectively in a team environment

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