Financial Counselor - Remote

Your job is more than a job

This job description is intended to describe the general nature and level of work performed by employees assigned to this department. This is not an exhaustive list of all duties and responsibilities, and LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

GENERAL DUTIES

Financial:

• Obtains necessary insurance information for patients. Answers questions or direct patients to appropriate staff members for questions regarding insurance, billing, payment and/or collection arrangements.
• Performs financial counseling on all patients prior to treatment, which includes explaining financial obligations and estimated costs of therapies based on insurance benefit plans & billing processes, as well as developing payment arrangements with patient.

Service:

• Utilizes the summary of patient reimbursement and liability forms and obtain appropriate approvals as required.
• Assist patients and families in exploring options for financial assistance.
• Follows up with patients and families for financial assistance needs.
• Works with patients and Patient Financial Services (PFS) to resolve account balance issues and establish payment plans.
• Applies department processes for non-profit, community, pharmaceutical, federal, state and health system financial assistance programs. Implements knowledge of federal and state requirements for assistance to patients with an inability to pay.

Quality:

• Documents the financial counseling process, discusses the EMR and forwards necessary documentation to the central business office.
• Assists physicians in determining approved regimens for treatment and ensuring that regimens are approved according to NCCN guidelines.
• Processes, monitors and documents apps for various programs.
• Demonstrates an understanding of the need for patient confidentiality to protect the patient and the institution. Follows all necessary HIPAA regulations to protect patient information.
• Provides information regarding patient data and status to other health system departments, physicians, staff and other public agencies while ensuring patient confidentiality.
• Follows policies and procedures to contribute to the efficiency of the front office. Assists with other front office functions as requested.

People

• Communicates details to the treatment team regarding any anticipated issues with coverage that may impact the sequencing and timeliness of care.

MINIMUM QUALIFICATIONS

• Required: High School Diploma/GED or equivalent OR 2 years of work experience in Registration/Pt Accounts or Billing Office.

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of all financial assistance programs, CMS guidelines, HIPAA regulations, billing and authorization guidelines, DHH Medicaid & Medicare coverage criteria and programs
• Working knowledge of healthcare insurance, particularly Medicare and Medicaid.
• Demonstrate knowledge of current resources and programs to assist the patient's need for financial resources, i.e., Social Security Disability programs.
• Strong knowledge of diagnostic (ICD-9), procedural (CPT), coding and cancer terminology.
• A high degree of computer literacy in a PC environment including basic Microsoft Office computer skills.
• Familiarity with basic functions of an EMR.

REPORTING RELATIONSHIPS

• Does this position formally supervise employees? No

FUNCTIONAL DEMANDS

• Sedentary: Very light physical requirements- Sedentary Work- Exerting up to 10 pounds of force occasionally (occasionally means activity or conditions exist up to 1/3 of the work day), and/or, a negligible amount of force frequently (frequently means activity or condition exists from 1/3 to 2/3 of the work day) to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PHYSICAL DEMANDS

• Sitting - Continuous (67-100% of day)
• Standing - Occasional (0-35% of day)
• Walking - Occasional (0-35% of day)
• Climbing (e.g., stairs or ladders) - Occasional (0-35% of day)
• Lifting Floor to waist level: 0-10lbs - Occasional (0-35% of day)
• Lifting Floor to waist level: 10-20lbs - Occasional (0-35% of day)
• Lifting Floor to waist level: 20-50lbs - Occasional (0-35% of day)
• Lifting Fl