Financial Counselor

Summary:

Provides financial counseling to patients by interviewing patients verifying insurance coverage establishing payment arrangements determining eligibility for financial assistance and other related activities to maximize reimbursement to the Hospital for services rendered.

Responsibilities:
Demonstrates understanding of Hospitals Mission Vision and Values.

Demonstrates understanding of job description performance expectations and competency assessment plan.

Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to our Customer Service Standards.

Complies with department and hospital policies and procedures.

- Reviews policies and procedures

- Reviews Employee Handbook.

Completes mandatory safety management education.

- Hospital-wide

- Department-specific

- Job-specific

Participates in departmental and/or interdepartmental quality improvement activities.

Reviews and analyzes all pre-admission admission and outpatient account data daily to determine each patients financial status.

Contacts patients employers and insurance companies as indicated to verify insurance coverage patient balance responsibilities and determines eligibility for assistance.

Meets with patients and/or their families to obtain needed third party billing forms signatures of financial responsibility collects private room balances insurance co-payments and deductibles due.

Reviews the scope type and terms of health insurance contracts with patients and their families utilizing the Hospitals financial policy to determine the adequacy of the coverage.

Determines selected patientseligibility for the Uncompensated Care and Bed Fund Programs by gathering the appropriate eligibility information to expedite approval or denial of assistance with the specified time frames of these programs.

Processes applications for Uncompensated Care according to the Federal Register regulations.

Refers patients in need of financial assistance to various state federal and other agencies and when necessary completes application obtains all required documents and files with the appropriate agency.

Provides information to these agencies relative to the financial obligation of the patient as requested.

Initiates applications for catastrophic health insurance programs as appropriate.

Follows up with patients who are rejected for assistance to discuss and arrange alternative reimbursement options before discharge from the Hospital.

Negotiates payment schedules with patient and re-negotiates these schedules as necessary to accommodate changes in the patients financial condition.

Initiates promissory notes and promissory note payment arrangements and obtains proper signatures on the notes.

Refers appropriate patients to selected banks to obtain loans for payment of Hospital services.

Utilizes a current and comprehensive knowledge of the Newport Hospital charge and rate schedule to establish adequate and firm payment arrangements.

Implements Newport Hospitals financial policies to maximize collections and decrease bad debts.

Develops and maintains effective working relationships with local physicians their office staffs and other Hospital departments to ensure mutual understanding and acceptance of the Hospitals financial policies and to correct errors and clarify misunderstandings.

Notifies other Hospital departments of reimbursement requirements relative to each individual patient account as appropriate.

Coordinates reporting of such information to the insurance carrier being mindful of patientsrights while ensuring maximum reimbursement from third party payers.

Documents all pertinent patient account information in the patient account notes regarding the scope of insurance coverage billing instructions prior payment listing and patientsplans for payment of balances due.

Revises and updates all patient demographic and/or insurance information in both Registration and Financial computer systems to ensure the continued accuracy of patient account data.

Arranges inter-bank transfers of funds for patient payments including the wiring of monies from banks outside of the United States.

Schedules patients family interviews for discussion of limitations of coverage or payment denial issues at the convenience of the family including hours beyond the regular scheduled business day.

Obtains additional information as needed from the patient and/or his/her representative to ensure the timely filing of a Hospital lien where a third party may be held liable for a patients injury.

Prepares a status report monthly which includes inpatients hospitalized over 30 days or whose balances exceed $15000.

Researches and resolves billing questions from walk-inpatients with the assistance of corporate customer service staff and Pre-collect company whenever needed.

Safeguards the confidentiality of all private information pertaining to patients.

Assists in the maintenance of a safe and secure environment for patients employees and visitors by immediately reporting unsafe or questionable conditions people situations or Hospital security violations to the Registration Manager of the Security Guard on duty.

Other information:
Qualifications:

Duties require high school education an advanced knowledge of third-party reimbursement and state and federal programs for the needy and excellent communication skills.

A basic knowledge of the registration process is also necessary.

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