Job Summary

The Financial Counselor performs the quality control function for the clinic, ensuring all pertinent information is available and accurately documented, allowing for timely and efficient billing. These activities include generating weekly status reports, communication with Revenue Cycle Director, monitoring accounts for proper documentation of third party review notification, authorizations, insurance verifications, collection of deposits and self-pay balances, computer update of accounts and the collection of verification of relevant patient data.

Duties

• Follows policy and procedures in regard to financial screening, arrangements and third-party demands
• Verifies and assures all accounts are ready for billing with adequate supporting documentation, within the established time frames
• Serves as support to patients and their family members to assure customers have access to all available funding, this involves; working with private as well as governmental agencies; i.e., private insurance, HMO/PPO’s, Medicaid, Medicare, Champus and Worker’s Compensation.
• Initiates and completes Charity Applications on accounts. Assists patients in completing State and county medically indigent application forms and schedules appointments, or follow up with patients to returned financial information
• Offer patients a Prompt payment discounts
• Payment Plan is also available for the patients (12 months)
• Reviews financial data with the patient to determine possible Medicaid eligibility. Refer patient to the Medicaid Eligibility Staff
• Determines patient’s ability to pay and secure repayment arrangement with patient, according to DePaul Community Health Center established polices.
• Prepares accounts for Supervisor’s approval
• Provides comprehensive audit and analysis
• Updates all clinics accounts to ensure completeness and accuracy
• Exercises problem solving skills independently and update system to resolve any patient account delay
• Monitors appropriate turn around on all accounts to ensure the business office within established time frames receives accounts
• Assures proper financial classification, determines proper guarantor and updates system accordingly
• Investigates Medicaid coverage for other coverage and restricted services
• Always handles all patient/family contact in a courteous, professional manner
• Consistently interacts with sensitivity to patients/their families and is responsive to individual needs
• Receives and places telephone calls in a skillful manner using appropriate etiquette
• Handles all telephone requests with courtesy, accuracy and respect for confidentiality
• Provides estimates for procedures to patients, as requested
• Consistently follows/reviews third-party guidelines for review notification and contract coding of patient accounts
• Alerts Supervisor/Director to patterns in problem areas in order to initiate situation resolution
• Performs duties in a self-directed manner with minimal supervision or direction

Qualifications

1. A high school diploma or its equivalent in required

2. Two years of hospital experience and working knowledge of all patients accounting functions, including admission registration

3. Demonstrated experience in credit, collection and billing is required, preferably in a hospital or clinic setting

4. Prior work experience operating a personal computer, in house computer system and other office equipment in required

5. Ability to interpret billing manuals, insurance and/or other third-party coverage

6. Understanding of the third-party review process

7. Understanding of payer funding and authorization procedures to ensure payment

8. Understanding of government/state payers, including eligibility factors

9. Knowledge of medical and insurance terminology is required

10. Ability to type 45 WPM

11. Must be proficient in the use of office machines, including computers

12. Must have excellent interpersonal and telephone skills

13. Must have effective written and verbal communication skills

14. Must possess patient interview techniques

15. Must obtain the ability to prioritize workload and possess ability to meet tight time frames

16. Must obtain the ability to work under minimal supervision, is detail oriented and possess

problem-solving skills

17. Must be able to withstand a frequent amount of working at a computer terminal

18. Must obtain the ability to concentrate on detail in the middle of other activities

19. Bilingual highly preferred

20. Must travel to other facilities