Financial Counselor I

KORE1, a nationwide provider of staffing and recruiting solutions, has an immediate opening for a Financial Counselor in Stanford, Ca.

The Financial Counselor Level 1 role screens uninsured and underinsured patients at bedside and prior to or post services to identify government or charity programs to cover medical expenses.

The position requires a patient financial interview which includes a review of hospital charges, the patient's insurance status and financial resources.

It may include the completion of appropriate applications and diligent follow up for approval. What you will do

• Finds solutions to help address patient financial needs in accordance with company policies and procedures.
• Determines financial clearance for a patient's visit or referral (pre-service or at time of service).
• Checks eligibility and benefits, determines authorization requirements have been met.
• Assesses "risk" of cases that have not been financially cleared / secured prior to service. Clears low risk cases, escalates high-risk cases to coordinator or manager.
• Contacts patient regarding steps required to clear their appointment for services including collecting a deposit for the patient's financially responsible portion.
• Quickly and accurately estimates a patient's out of pocket costs and prepares documents to present to the patient for payment.

Assures secure handling and accurate recording of payments collected at the point-of-service delivery.

• Applies strong problem solving skills to help address the concerns and needs of the patients that the Financial Counselors serve.
• Effectively communicates, both orally and written, to a variety of individuals including : patients, case workers, social workers, hospital directors and executives while maintaining utmost professionalism.
• Maintains professional communication with various Patient Financial Clearance and Patient Access Services staff, medical center staff, physicians, guests, and patients regarding the services rendered at the hospital.
• Communication may consist of telephone correspondence or in person contact.
• Must be multi-task orientated with excellent critical thinking skills and possess the ability to appropriately handle complexity and stress within the changing needs of the patients, families and the health system.
• Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager / Coordinator(s).

Qualifications :

• High school diploma or GED equivalent
• At least 1 year of progressive responsibilities in a hospital or clinic financial counseling role with knowledge of pre-authorizations and reimbursement regulations pertaining to Medicare, Medi-Cal, and children's health programs, with previous experience working in a metrics-based environment driven by financial counseling goals (such as screening rates and collection goals)

Required Knowledge, Skills and Abilities

• Bilingual preferred (English and Spanish)
• Demonstrates proficiency as applicable with Epic, insurance websites, POS payment systems, web-based screening tools
• Knowledge and understanding of Microsoft applications (Word, Excel, PowerPoint)
• Strong knowledge of eligibility and enrollment requirements for Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc.

Children's Health Programs (CCS, GHPP, Healthy Families, etc.)

Experience resolving issues in financial reimbursement billing, utilization management and government programs

Prior experience calculating, communicating and educating patient's on their financial responsibilities