Employment Type:

Full time

Shift:

Description:

The Financial Counselor is responsible for meeting with patients/guarantors, who require assistance in seeking and applying for healthcare funding (e.g., Charity Care, Medicaid, or other local/governmental funding program) and/or require assistance in reviewing and establishing payment options. The Financial Counselor is responsible for a broad spectrum of duties, beginning with the initial patient contact, via the pre-admit/pre-registration functions and ending with the control and maintenance of the patient’s account until discharge. Within this range, the Financial Counselor is responsible for determining the financial status of the patient during the financial counseling process. May also perform cashier and customer service functions.

SCOPE OF SERVICE/CUSTOMER:

The Financial Counselor is responsible for meeting with patients/guarantors, who require assistance in seeking and applying for healthcare funding (e.g., Charity Care, Medicaid, or other local/governmental funding program) and/or require assistance in reviewing and establishing payment options.  The Financial Counselor is responsible for a broad spectrum of duties, beginning with the initial patient contact, via the pre-admit/pre-registration functions and ending with the control and maintenance of the patient’s account until discharge.  Within this range, the Financial Counselor is responsible for determining the financial status of the patient during the financial counseling process.  May also perform cashier and customer service functions.

ESSENTIAL FUNCTIONS:

Knows, understands, incorporates, and demonstrates the Mercy Medical Center Mission, Vision, and Values in behaviors, practices, and decisions.  

Performs activities that relate to financial counseling for multiple patient types (Inpatient Admissions, Outpatient Observation and Bedded Outpatients, Diagnostic Outpatients, Ambulatory Surgery, Emergency Department Registrations, Series accounts, etc.), dissemination of patient information, and support coverage of other departmental divisions.  Frequent communications will occur with patients/family members/guarantors, 3rd party payers, local/governmental agencies, attorneys, employers, physicians/office staff and contracted vendors/agencies in the deployment of key activities.  Internal contacts include the Pre-Service unit, Patient Access, Social Work Services, Utilization Review/ Case Management, Ancillary and Nursing department staffs. Assists patients in completion of Medicaid and/or charity applications.

Monitors reservation and scheduling information to initiate the financial counseling process on a pre-service, time-of-service and post-service basis.  May interview patient and/or their representative either by telephone or in-house to accurately update demographic, clinical, financial and insurance data necessary to complete the financial counseling process.  Activities may occur in multiple locations, including patient access points of service, ancillary departments, patient nursing units, Emergency Department, as well as via telephone.  Reviews prior account notes for any information that might aid in the application/payment process, as well as documents all encounters and actions.  Ensures that all accounts are properly classified in the patient accounting system:

• All Self-Pay (uninsured) accounts will be screened within 24 hours of service with focus on high dollar accounts (Inpatient Admissions, Outpatient Observation, Bedded Outpatients, Ambulatory Surgery and designated Diagnostic Outpatients);
• High dollar patient liabilities, including outstanding balances; and
• Under-insured accounts (e.g., out-of-coverage, exhausted benefits, etc.) will be screened upon identification or upon patient/guarantor request.

Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.  May calculate patient liabilities, conduct credit scoring and propensity to pay modeling in order to determine the patient/guarantor’s ability and propensity to pay for services.  Provides financial education and outline potential funding options, as appropriate.  In the collection of funds, the incumbent documents payments/actions in the patient accounting system and provides the patient with a payment receipt.  

5.   Seeks appropriate funding based upon patient requirements, collecting supporting documentation (payroll stubs, tax returns, credit history, etc.), as required.  Provides information and education to the patient, family member and/or guarantor of the application/documentation process.  In so doing, the in