Financial Counselor

The primary focus of the Financial Coordinator is screening assigned self-pay pre‑admits (Inpatient and Out), Inpatient Emergent and Urgent Admissions and meeting with Emergency Room patients after treatment for insurance information not obtained at the time of registration, making self‑pay payment arrangements with patients who have the ability to pay prior to, during or after their service, screening and assisting patients with the Mass Health/Low Income/Commonwealth Care application process (entering the information into the Virtual Gateway online application) and the Medicare Indigent Free Care application process(includes visiting patients in their rooms).

The coordinator refers inpatient self pay and Medicare with no secondary coverage admissions to our vendor, to interview patients and assist the patient with the MH/LI/CC application process. If our vendor is not available, the Financial Coordinator visits the patient in their room to start the application process. The coordinator also refers inpatient psych admissions to our vendor, Health Care Financial Associates, to interview and assist patients with the application process.

The coordinator is responsible for interviewing all potential elective self-pay Inpatient Secap patients for payment arrangements and/or Mass Health/Low Income/Commonwealth Care eligibility once Secap has determined the clinical appropriateness of the admission (this is a face to face interview).

The Financial Coordinator is responsible for the pre‑certification and insurance verification processes at the time they obtain any insurance billing information. Insurance information obtained during the pre‑admit review or during the admission must be communicated to the Care Management and Patient Access Departments as soon as it has been verified.

The Financial Coordinator responds to incoming telephone calls and walk‑in patient visits to discuss bills and assists any person who wants to apply for MH/LI/CC assistance. The coordinator follows up on all pending applications to ensure that all documents needed for the application process are obtained and either faxed to the local Mass Health Enrollment Center or mailed to the Central Processing Unit.

The coordinator also assists clients with insurance billing issues as necessary.

Performs any duties requested by the Supervisor of Financial Coordination, the Credit & Collection Manager and/or the Regional Director of Patient Financial Services.

• Interview patients in their hospital room for personal/financial information.
• Request and accept payments.
• Process Mass Health/Low Income/Commonwealth Care and Medicare Indigent applications

• Provides superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards.
• Screen self‑pay patients for potential insurance information not obtained at the time of registration.
• Perform pre‑certification, insurance verification functions for identified insurance. Verify through Internet (Web based payor solutions, Point of Service Devices, telephone calls to Patients, Employers, Schools). Update accounts with demographic and financial information for billing purposes.
• Notify Care Management and Patient Access Departments of all changes.
• Screen self‑pay patients for ability to pay, advise patients regarding methods of payments.
• Accept (this includes setting up payment plans), request and collect deposits prior to the date of service, at the time of service or during the patient's hospital stay.
• Screen self‑pay patients for potential Mass Health/Low Income/Commonwealth Care assistance and assist with the application process, which includes completing and submitting the online Virtual Gateway application and follow up with the patient for additional information and follow up with Mass Health to obtain eligibility. (
  
  Note:
  
  Most inpatient accounts are now outsourced to a firm to handle the interview and application processes). The Financial Coordinator is responsible for covering for the outsource employee and working accounts assigned by Management.
• Interview SECAP patients for…