GENESIS HEALTHCARE SYSTEM
 

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. 

Position Details:

Work Shift:

Day Shift (United States of America)

Scheduled Weekly Hours:

40

Department:

Financial and Revenue Cycle Administration

Overview of Position:

The Senior Resource Counseling Associate 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 incumbent works with patients 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.;

ESSENTIAL DUTIES
1.    Functions as financial counselor for multiple patient types throughout the hospital for inpatient and outpatient activities. 
2.    Communicates with patients, family members/guarantors, 3rd party payers, local/governmental agencies, attorneys, employers, physicians/office staff and contracted vendors/agencies and various internal staff in the deployment of key activities.
3.    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 person to accurately update demographic, clinical, financial and insurance data.  Reviews prior account notes for any information that might aid in the application/payment process, as well as documents all encounters and actions.  
4.    Ensures that all accounts are properly classified in the patient accounting system.  Self-pay (uninsured) accounts will be screened within 24 hours of service, or next business day, with focus on high dollar accounts; high dollar patient liabilities, including outstanding balances; and under-insured accounts will be screened upon identification or upon patient/guarantor request.
5.    Informs patient/guarantor of their liabilities and collects appropriate patient liabilities, including co-payments, co-insurances, deductibles, deposits and outstanding balances.  May calculate patient liabilities and conduct credit scoring and propensity to pay modeling in order to determine their ability to pay for services.  Provides financial education and outlines potential funding options, as appropriate.   Documents payments/actions in the patient accounting system and provides the patient with a payment receipt.   
6.    Seeks appropriate funding based upon patient requirements, collecting supporting documentation as required.  Provides information and education to the patient and/or family member of the application process.  Encourages patient participation in the application process and assists the patient in forwarding the required documentation and application to the appropriate funding agency.
7.    Follows up on eligibility applications status and provides appeal assistance, as appropriate.  Follows up on the collection of payments from settlements, payment arrangements, out-of-network settlements, and specialty services (e.g., cosmetic, worker’s compensation, auto accident, etc.) and determines course of action for non-cooperative patients (e.g., collections placement).
8.    Investigates No Fault and Workers’ Compensation cases, retrieving police report and insurance information, as required
9.    Works with contracted vendors/agencies to qualify applicants, reviewing each case prior to agency placement.  Obtains and distributes accounts for litigation, credit consolidation, tax purposes, bad debt recovery, etc. May meet with the contracted vendors/agencies to discuss policies, procedures and pending issues; maintains statistics of vendors/agencies’ outcomes.  May write-off accounts based on Genesis guidelines.
10.    Assists staff in other departments including: Social Work Services in establishing Medicaid pending cases for placement in long-term care facilities or home healthcare, and UR/Case Management in documenting clinical information and soliciting assistance in clinical documentation from the medical staff.   
11.    Assists in identifying and obtaining funding for additional services required after discharge, establishing ong