Financial Counselor

Overview

The Financial Coordinator screens self-pay pre-admits (Inpatient and Outpatient), Inpatient Emergent and Urgent Admissions, and meets with Emergency Room patients after treatment to obtain insurance information not collected s role makes self-pay payment arrangements and assists with Mass Health/Low Income/Commonwealth Care (MH/LI/CC) and Medicare Indigent application processes, including entering information into the Virtual Gateway online application. The coordinator also visits patients to support the application processes and refers admissions to the vendor when appropriate.

The coordinator is responsible for interviewing potential elective self-pay Inpatient Secap patients for payment arrangements and/or MH/LI/CC eligibility after Secap determines the clinical appropriateness of the admission (face-to-face interview).

The Financial Coordinator handles pre-certification and insurance verification at the time insurance billing information is obtained, and communicates verified information to Care Management and Patient Access Departments promptly.

The coordinator responds to incoming calls and walk-in visits to discuss bills and assist with MH/LI/CC applications. The coordinator follows up on pending applications to ensure required documents are obtained and submitted to the local Mass Health Enrollment Center or Central Processing Unit, as applicable. The coordinator also assists clients with insurance billing issues as needed.

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

The Financial Coordinator is authorized to:

• 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.

• Provide superior customer service to internal and external clients and patients.
• Screen self-pay patients for potential insurance information not obtained at the time of registration.
• Perform pre-certification and insurance verification functions for identified insurance verification, via Internet (web-based payor solutions), Point of Service devices, and communications with patients, employers, and 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 and advise on methods of payment (including setting up payment plans); request and collect deposits prior to service, at the time of service, or during the hospital stay.
• Screen self-pay patients for MH/LI/CC assistance and assist with the application process, including completing/submitting the online Virtual Gateway application and following up for additional information; most inpatient accounts may be outsourced to a firm to handle the interview and application processes. The Financial Coordinator covers for outsourced staff as needed and works accounts assigned by Management.
• Interview SECAP patients for ability to pay prior to admission; request/collect payment before admission if able; complete MH/LI application if indigent; notify Unit Secretary when financial arrangements are completed.
• Meet with Emergency Room patients after ER service for missing insurance information and assist with MH/LI/CC application processes (including online submissions) and follow up as necessary.
• Request self-pay payments in the ER after service, when the patient has the means to pay.
• Request and collect deductibles and co-pays on pre-admits when self-pay pre-admits or in-house accounts have insurance.
• Obtain Motor Vehicle Insurance Information and file Liens when necessary to protect the medical center’s interests.
• Respond to all incoming calls and walk-in visits related to hospital accounts; assist clients to ensure positive outcomes for patients and the medical center.
• The Financial Coordinators see clients in the ER and in the St. Margaret’s Lobby office; employees may be floated between locations.
• Collaborate with Free Care Coordinators to ensure the information/documents needed to process a Medicare Indigent application are available.
• Update accounts with third-party billing information as necessary.
• Work with Multi-Lingual Advocates as a referral source and for interpretive services.
• Maintain current knowledge of insurance carrier coverage and exclusions that may impact patients.
• Operate standard office equipment (calculator, POS devices, Medicare/Blue Cross terminals, FAX, copy machines, scan station).
• Assist with training of new employees.
• Perform duties as requested by Supervisor or Credit & Collection Manager.

B. Responsibilities/Non-Essential Functions:

• Scanning/Photocopying

Reports to the Supervisor of Financial Coordination. Reports problem accounts to the Supervisor timely. Reports major events or serious matters related to the…