Patient Financial Counselor in Conway, South Carolina at Conway Medical Center

Position Title: Patient Financial Counselor

Position Summary: The Patient Financial Counselor determines client eligibility for enrollment in available community programs including local funding and/or Medicaid. The Patient Financial Counselor is responsible for delivery of high-quality customer service with attention to special needs of a diverse client base. Employees must apply technical knowledge to analyze application materials to make appropriate decisions regarding client eligibility and ensure appropriate application of policies and procedures. Qualifications: Education:

• High School Diploma or equivalent required.

Experience

• Minimum of three (3) years’ General Patient Accounting experience.
• Minimum of two (2) years’ Customer Service experience.
• Knowledge of Medicare, Medicaid, HMO, PPO and Commercial guidelines.
• Working knowledge of Word, Excel and other Microsoft applications.
• Effective communication skills and excellent working relationships with patients and physicians.

Licensure/Certification/Registration

• AAHAM OR CRCS Certification preferred.
• Certification with SCDHHS (Heath Exchange Program) within 12 months of hire required.

Duties & Responsibilities:

• Requires fundamental knowledge of Conway Medical Center collection policies and procedures as well as other positions for Financial Assistance.
• Collect all inpatient and observation out-of-pocket expenses while the patient is in-house. Out-of-pocket expenses include, but are not limited to deductible, co-payments, services excluded by insurance plan, and/or self-pay negotiated amount due.
• Timely and accurate review of Charity Pending requests, request for copies of Itemized bills or claims, and incoming mail.
• Responsible for following up on all Financial Assistance requests through email/Patient Portal/telephone.
• Assist patients with the application process to include the Heath Exchange Program.
• Schedule appointments with patients to collect financial statements, unemployment, social security, and any other funding.
• Greet all patients and their accompanying family members when applicable and provide exemplary customer service.
• Coordinate with outside agencies for the patient qualifications of Conway or the State of South Carolina.
• Serves as a source for patients that exceed the Health Care District Coordinated Care FPLG (Federal Poverty Level Guidelines) but meets Charity Care FPLG.
• Interview people in need of services and assist them in navigating the documentation process.
• Must possess knowledge of Medicare, Medicaid, HMO, PPO, and Commercial guidelines.
• Review inpatient and observation admissions for adequate payer source and establishes a plan to secure payment resources to maximize hospital reimbursement.
• Work effectively and collaboratively with colleagues, physicians, and department heads.
• Effectively utilize strong organizational skills.
• Consistently display effective verbal communication skills.
• Proficient understanding and use of technology/PC skills required.
• Regularly exercise independent judgement.
• Complete other duties as assigned by department leadership.