financial Counselor - financial Assistance Center
Company: North Oaks Health System
Location: Hammond
Posted on: January 27, 2023
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Job Description:
Status: Full Time
Shift: Monday - Friday 8-4:30 varies
Exempt: No
Summary:
Performs account follow-up and resolution of patient
receivables.
Other information:
Education:
High school graduate or equivalent is required
General math skills required
Experience/Skills:
Minimum of two years of customer service, problem resolution and
telecommunication experience.
Hospital billing experience desirable.
Knowledge of Medicaid and Charity Care. Working knowledge of
billing, benefit verification, pre-certification and reimbursement
policies of third party payers required.
Medical terminology helpful.
Data entry and computer skills.
Excellent written and oral communication skills.
Physical Demands:
Strength: Sedentary
Push: Occasionally
Pull: Occasionally
Carry: Occasionally
Lift: Occasionally
Sit: Constantly
Stand: Occasionally
Walk: Frequently
Responsibilities:
1. On a daily basis, monitor and interact with the patient/family
member to screen and provide various types of financial assistance
to patients while maintaining positive public relations.
2. Screen patients for all Medicaid Programs, Supplemental Security
Income, and Financial Assistance. Complete and process applications
as appropriate.
3. Maintain follow up on Medicaid and Financial Assistance
applications for approval. Medicaid follow up in 15 days after
submission and Financial Assistance needs to be followed through
until a final determination is received.
4. Verify, obtain and if necessary correct Insurance information
and add appropriate carrier/plan information, ensuring that all
steps have been completed so that proper billing, follow up and
reimbursement can be obtained.Insurance information may be obtained
from the patient through a phone call, walk-in, mail, etc.
5. Have working knowledge of insurance billing, insurance
reimbursement and third party payer specifications in regard to
admission criteria, pre-certification, prior authorization or
second opinion requirements.
6. When necessary, complete a Charity Care Assistance Application
for "indigent care" patients. This process includes gathering
financial information, completing the application, noting all
accounts, routing all information for approval.
7. When necessary, interact with Social Service, Case Management,
Insurance Verification and Nursing Units involving patient
financial concerns.
8. Ability to work well under stressful conditions, including the
ability to affectively assist an irate patient and/or family
member.
9. Make financial agreements, per the Payment Plan Policy,
including but not limited to employee payroll deduction.
10. Obtain monetary collections on a patient's account(s) either by
a deposit on an account, first payment of a payment plan, and/or
payment in full.
11. Immediately follow up on paperwork received Resolution
Analysts, Admit Scheduling, or Insurance Verification Personnel for
private pay patients or patients with a large deductible or
co-payment. This follow up includes but is not limited to verify
the insurance coverage, obtaining additional insurance information,
requesting a deposit from the patient/family member.
12. Research and write up account adjustments on the proper
adjustment form and route for the appropriate signatures of
authorization, as outlined in the adjustment policy when
necessary.
13. Prepare and present Medicare notice of observation status to
patients and document findings.
14. Research financial records and returned mail on a daily
basis.
15. While reviewing a patient account history if an account with a
credit balance is identified refer the account to the appropriate
employee to research and process third party and patient refunds
and/or to correct the misapplication of funds.
16. Refer accounts to Nurse Auditors, according to the policy, for
a patient request audit of the account charges when necessary.
17. On a daily basis, promptly process mail to obtain account
information as received.
18. Assist with the training of new employees.
19. Provide patients with COIB upon request whether request is from
daily mail, phone call or walk-in.
20. Contact Medicaid, Medicare, Commercial Insurances, and/or Third
Party Payers for status of claims on a daily basis.
21. Contact Collection Agency on Bad Debt accounts when necessary;
including researching and resolving collection agency
correspondence.
22. Help resolve problem admissions according to hospital financial
policy when necessary.
23. Work reports as assigned by Supervisor/ Coordinator/ Director
within time frames set for each report.
24. Transfer balances to patient balance daily after insurance
pays, denies or when deemed appropriate.
25. Call or write patients, insurance companies and employers for
additional information needed to process claims when necessary.
26. Request medical records when needed to process claims or
resolve a patient concern on an account.
27. Serve as the back up to the NOMC Cashier and Collection
Specialist as needed.
28. Handle special requests and administrative overrides on
accounts from Administration.
29. Report patient concern in full detail to Patient Financial
Services Management to enter into Quantros for follow up.
30. Daily document in system notes all factual information and
activities pertaining to the account.
31. Consistently have open communication with all hospital
departments.
32. Maintain confidentiality and adhere to HIPPA Compliance.
33. Attend in-services and other meetings as required.
34. Efforts must be made to achieve and exceed departmental goals
on an ongoing basis.
35. Must maintain performance and productivity levels set within
the performance indicators.
* Follow North Oaks Health System policy and procedures, compliance
program and all Federal and State regulatory guidelines.
* Complete all educations assigned via Net Learning.
38.Perform other duties as assigned.
*
Keywords: North Oaks Health System, New Orleans , financial Counselor - financial Assistance Center, Other , Hammond, Louisiana
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