Patient Financial Counselor-Division Support in Ann Arbor, Michigan at Trinity Health - IHA

POSITION DESCRIPTION: The Patient Financial Counselor-Division Support acts as a financial advocate for the patient and as liaison between the office, Revenue Site Operations (RSO) and Patient Financial Services (PFS). Under limited supervision, determines liability on patient accounts and works with patients or their representatives to provide financial assistance or secure payment. Reviews explanation of benefits and denials to assist in third party collections when possible. Assists in training and workflows with the reception team to meet and exceed the established goals of increased collections with greater patient satisfaction. Assists in obtaining coordination of benefits information and medical necessity documentation. Regularly follows up with patients, office staff and RSO. This position explores financial assistance options including Access One, payment plans, as well as assisting in reaching out to the appropriate departments for Medicaid and financial relief programs available through the organization. Works closely with providers and staff to obtain all necessary information for claim corrections.

ESSENTIAL JOB FUNCTIONS:

Counsels patient on cost of treatment, insurance benefits, resources for payment and financial assistance. Secures and documents payment arrangements.

Advocates for patient customer service escalations.

Audits bills for accuracy.

Works work queue edits for front-end inaccuracies to increase collections and decrease write-offs. Works closely with RSO and division leadership to improve collections.

Reviews delinquent accounts to ascertain previous collection action taken, status and extent of insurance coverage and potential collectibles.

Assists with medical necessity documentation required to get claim(s) paid.

Makes outbound calls to patients to assist in third party collections and establish payment options when insurance has been exhausted.

MyChart communication, as well as phone calls and letters, will be an essential function of this position with many outbound calls to ensure collections from insurance carriers as well as patients.

Assists patients in Access One financing, payment plans, financial assistance and all financial options through the organization.

Manages Medicaid Pending work queue and assists with financial options for patient to get claims billed/paid.

Reviews and analyzes rejections that may become patient responsibilities; this will include managing the workflow and rejection reports/WQs for the division.

Properly documents in Epic and communicate.s with billing team effectively.

Assists with Coordination of Benefits (COB) denials and works with patient/insurance for resolution to completion.

Assists in training and educating front desk staff on correct workflows.

Assists provider with correct workflow if a claim needs to be corrected (Reposts workflow).

As a member of the Reception Leadership team and the Collections Committee, you may be required to do presentations and answer questions from the divisions.

Travels between other offices and the central office to train, assist and attend necessary meetings and trainings.

Performs other duties as necessary.

ORGANIZATIONAL EXPECTATIONS:

Creates a positive, professional, service-oriented work environment for staff, patients, and family members by supporting the mission and values of both IHA and Trinity Health.

Must be able to work effectively as a member of the financial advocacy team.

Successfully completes IHA’s “The Customer” training and adheres to IHA’s standard of promptly providing a high level of service and respect to internal or external customers.

Maintains knowledge of and complies with IHA standards, policies, and procedures.

Maintains complete knowledge of office services and in the use of all relevant office equipment, computer and manual systems.

Maintains strict patient and employee confidentiality in compliance with IHA and HIPAA guidelines.

Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respects cultural differences.

Uses resources efficiently.

If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

MEASURED BY:

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:

EDUCATION: High school diploma or equivalent education and experience. Medical billing or medical billing training preferred.

CREDENTIALS/LICENSURE: NA

MINIMUM EXPERIENCE: 2 years of front desk experience required; Epic experience preferred.

POSITION REQUIREMENTS (ABILITIES & SKILLS):

Ability to properly document in Epic and communicate with billing team effectively.

Sufficient knowledge of medical terminology to perform responsibilities.

Understanding of basic billing and coding. Ability to read an explanation of benefits.

A willingness to research claim denials and explore all options for COB.

Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, Microsoft Word, Excel, electronic medical records (EPIC), intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job.

Excellent communication skills in both written and verbal forms, including proper phone etiquette.

Ability to speak before groups of people, either in-person or virtually.

Ability to work collaboratively in a team-oriented environment; displays courteous and friendly demeanor.

Displays a friendly manner and a willingness to advocate and assist the patient with their financial options.

Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, patients, family members, insurance carriers, and vendors.

Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.

Good organizational, time management and project management skills to effectively juggle multiple priorities and time constraints.

Strong analytical and critical thinking ability along with superior problem-solving ability. Ability to exercise sound judgement.

Ability to handle patient and organizational information in a confidential manner.

Ability to attend all reception leadership meetings.

Ability to travel to all IHA offices as needed.

Successful completion of IHA competency-based program within introductory and training period.