The Patient Financial Counselor is responsible for assisting patients in the process of completing financial assistance applications, educating them about their financial responsibility, and helping them identify a path toward resolving their balances. This position also acts as a liaison between customer service and the patient answering billing questions as they arise. This position involves communicating with patients in person, over the telephone and via written communication requiring the highest level of customer service.

MISSION, VALUES and SERVICE GOALS

• MISSION: We deliver outstanding care, inspire health, and connect with heart.
• VALUES: Trust. Respect. Integrity. Compassion.
• SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Patient Financial Counselor Duties:

• Pre-screens uninsured and underinsured patients to identify potential financial assistance opportunities.
• Identifies patients who may need a Medicare Beneficiary Notices of Non Coverage or any other waiver signed acknowledging patient responsibility prior to service.
• Follows up with all patients who have not been financially cleared prior to discharge (or because their service was urgent/emergent) to help them navigate their responsibility and determine if they have a financial need.
• Provides patients with personalized estimates of their financial responsibility based on their insurance coverage or eligibility for government programs prior to service for both inpatient and outpatient services.
• Assists patients without valid insurance coverage with enrollment in programs including, but not limited to, Medicare, Medicaid, and other state-based assistance programs.
• Documents all payer communications and pre-service patient financial conversations, including payer decisions, collection attempts, and payment plan arrangements.
• Ensures financial assistance applications are accurately filled out and complete before sending to the application processing team for review.
• Works in conjunction with on-site state social worker or outside eligibility vendor to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized based on patients' eligibility.
• Reviews and evaluates the patient's qualification for Financial Assistance according to the policy ensuring all required documents are collected and signed.
• Calculates and provides patients with personalized estimates of their financial responsibility based on their insurance coverage or eligibility for financial assistance according to Beacon Health System's policy.
• Initiates collections attempt on arranged payment plans or services/fees that were discounted.
• Helps patients develop a plan to resolve their liabilities, including by setting patients up on payment plans according to the established guidelines.
• Educates patients on their insurance coverage, such as by providing explanations of common terms (e.g., copay); their billing statements to prevent confusion; and any other questions patients may have about their financial responsibility.
• Stays informed of any statutes and regulations that could affect the collection of receivables (e.g., insurance company changes, collection regulations, etc.)
• Completes daily administrative tasks as necessary, such as filing, processing paperwork, and documenting interviews with patients.
• Collects payments from patients either pre service or post service and processes them within the payment portal.
• Creates deposits for cash when needed and prepares transactions for bank pick up.

Performs other functions to maintain personal competence and contribute to the overall effectiveness of the department by:

• Completing other job-related assignments and special projects as directed.

ORGANIZATIONAL RESPONSIBILITIES

Associate complies with the following organizational requirements:

• Attends and participates in department meetings and is accountable for all information shared.
• Completes mandatory education, annual competencies and department specific education within established timeframes.
• Completes annual employee health requirements within established timeframes.
• Maintains license/certification, registration in good standing throughout fiscal year.
• Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
• Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
• Adheres to regulatory agency requirements, survey process and compliance.
• Complies with established organization and department policies.
• Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:

• Leverage innovation everywhere.
• Cultivate human talent.
• Embrace performance improvement.
• Build greatness through accountability.
• Use information to improve and advance.
• Communicate clearly and continuously.

Education and Experience

• The knowledge, skills, and abilities as indicated below are normally acquired through the successful completion of a High School Diploma. Previous experience in customer service or a related field is preferred. An advanced degree is preferred. General knowledge of insurance.

Knowledge & Skills

• Demonstrated technical knowledge of the UB04 and CMS1500 claim form and 837i/837p requirements and its use and application for third party billings.
• Demonstrated technical knowledge of government agency policies, procedures, regulations and requirements.
• Demonstrated technical knowledge of Third Party payer policies, procedures, regulations and requirements.
• Organizational skills necessary to manage and control automated and manual claim submission.
• High level of customer service and professional customer interactions.
• High level of comfort working with computers and other technology and software programs including Microsoft Office.

Working Conditions

• Prolonged exposure to computer terminals.
• Direct interaction with patients digitally and/or in person.

Physical Demands

• Occasional lifting of storage boxes weighing up to 50 pounds when filled with completed forms.
• Long periods of sitting or standing.