PAS Financial Counselor

Work Shift

Day (United States of America)

The PAS Financial Counselor III represents the Hospital in financial matters pertaining to obtaining payment on patient accounts during pre-admission, inpatient, and outpatient phases of the patient's visit. Acts as intermediary with Admitting, Business Office, patients, and family members while the patient is hospitalized. Coordinates full patient financial counseling, education & referrals, employs and completes all patient liability collection escalations through proper collection of all estimated patient liabilities, including co-payments and unmet deductibles before, during and after time of service.

Verifies insurance benefits and coverage for inpatients and outpatients. Responds to customer requests and answers questions regarding various service and account information. Analyzes and rectifies customer concerns using established procedures. Uses computer to access and/or update customer records. Verifies and posts transactions. Follows established procedures for processing receipts, cash etc. Sorts and files various documents. Assists with general hospital information and directions to departments within and outside of the WHS facility.

Establishes financial arrangements to reduce financial risk for WHS, helping to ensure that Well Star is reimbursed for its services. Responsible for promptly and efficiently responding to patient inquiries regarding charges and account settlement. Information is collected and responded to via phone or in writing for email and written letters. Working knowledge of the rules and regulations pertaining to government programs.

• Quality/ Safety a. Reviews daily census and visits hospital patients when appropriate, verifies patient coverage, benefits, and collects estimated patient liable amounts. b. Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information. c. Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third party payer. d.
  
  View charges to determine financial estimates and collects appropriate co-pays/ and or deductibles. e. Makes corrections and updates patient account information in computer. f. Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes. g. Maintains a working knowledge of available information system capabilities and performs all system applications that are required. h. Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as re-lated to assigned duties.
  
  Understands the admission, outpatient and emergency registration process. i. Maintains confidentiality of patient information, in accordance with WHS policy and HIPAA regulations. j. Consistently demonstrates the ability to organize work recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs. k. Maintains proficiency in data entry skills. l. Assists with Medicaid screening on all accounts.
  
  m. Resolves error in Patient Work Queues
• Budget/Financial a. Attempts to collect the estimated self-pay balance of all inpatient, outpatient and ER accounts, at the earliest possible collection control point. b. Monitors in-house accounts and attempts to make financial arrangements with guarantors for payment of their self-pay balances in full, prior to discharge, or within ten working days thereafter. c. Communicates with Medicaid Eligibility team and applicable vendor(s) to determine eligibility and approval/ denial status, as needed.
  
  d. Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities. e. Identifies those patients without adequate insurance coverage. Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs (namely Medicaid). f. Maintains a list of health care financial assistance programs and the eligibility requirements for each program.
  
  Refers patients/guarantors to sources of outside funding assistance, distributes financial assistance (i.e. Medicaid) applications as need. g. Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow. h. Interviews all inpatients and select (self-pay) outpatients at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
  
  i. Documents concise and understandable notes regarding all self-pay account collection activity, as well as each patient or guarantor interaction. Documents all efforts to collect patient account balances, other self-pay collection activities and referrals to Medicaid. j.…