University of Rochester Financial Counselor in Rochester, New York
Full Time 40 hours Grade 009 Financial Counseling&Outpt; Reg
The Financial Counselors assess all aspects of patient financial account management for all visits on any urgent; emergent; preadmission; and ambulatory level. The Financial Counselors are accountable for coordinating all activities necessary to financially secure the defined case load through the verification process; requesting deposits for non-covered services and co-pays; resolving complex problems that include but not limited to pre-certifications; Utilization Management; coordination of benefits; baby not on policy; Cobra entitlement; Medicare Life Time Reserve days; and Medicare Advantage issues. Involves in-depth communication; collaboration; and follow-up with patients; families; third-party payers; governmental agencies; employers; social work; financial case management; and utilization management. The Financial Counselors are ultimately responsible for minimizing any delays from admission until the final bill is produced.
Creates a professional and effective customer oriented environment by utilizing excellent communication skills to obtain pertinent demographic information; confirms insurance information; discusses financial obligation; obtains patient agreement signature; documents demographic and insurance information in a timely, accurate manner in the hospital computer system following department and hospital standards.
- Reviews each visit for insurance history by utilizing the hospital system along with all third party payer systems.
- Obtains benefits; pre-certification requirements and/or completes notification of admissions.
- Identifies and confirms self-pay patients for appropriate referral to Financial Case Management for possible Medicaid application and/or Charity Care.
- Notifies and monitors parents for completion of paperwork when babies are not on the policy.
- Notifies and monitors patients COBRA entitlement and assist with paperwork if necessary.
- Identifies pre-existing conditions during the insurance verification process for lapse or creditable coverage.
- Determines the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits.
- Notifies Utilization management of clinical requests by third party payers.
- Maintains a monitoring system for adequate benefit coverage and eligibility throughout the inpatient stay.
- Accountable for meeting department standards for completion and QA visits on a day to day basis by utilizing Hold Bill and Visit Manager work lists.
- Consistently monitors current admission to ensure eligibility and additional clinical requirements.
- Notification of admission to third party payers are within the 24-48 hour guideline.
- Observes discharged visits on the Hold Bill work list daily for potential cases that may require notification to insurance companies.
- Ensures Medicare compliance with the Office of the Inspector General guidelines by notifying patients of exhausted Medicare benefits and the option of utilizing their lifetime reserve days.
- Monitors the ALC report for any level of care changes and ensure there is coverage.
- Reviews Medicare for MSP questions and validation.
- Checks Medicaid eligibility every 30 days for active coverage.
- Attends educational programs for the department at the Manager’s direction.
- May train or perform other duties assigned by management.
AAS in related discipline (admitting/registration/patient billing/insurance) with 3 years of related experience, preferably in a hospital setting, or an equivalent combination of education and experience. Require high degree of professionalism and motivation with excellent communication and customer service skills; strong computer skills and ability to type 25 words per minute. Prefer medical terminology. Flexible to work weekends, other assigned hours and/or responsibilities as needed.
EOE Minorities/Females/Protected Veterans/Disabled
Job Title: Financial Counselor
Location: Strong Memorial Hospital
Job ID: 202358
Full/Part Time: Full-Time