Patient Access Financial Counselor

SUMMARY :

Interviews patients or responsible representatives to arrange methods of payment of extension of credit. Secures information relative to patient’s financial status, evaluates credit history and determines payment dates based patient’s ability to pay and credit and collection policies.

Approves or disapproves extension of credit. May secure assignment of benefits or may recommend other sources of credit.

ESSENTIAL FUNCTIONS :

adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication.

Collects deposits or deductibles as required and advises patient or guarantor of insurance benefits and anticipated cost estimates;

ensures cash handling follows corporate policies.

Ensures completion of financial documentation in accordance with TMCH’s credit and collection policies.

Performs medical necessity screening and ensures compliance with system requirements.

Explains all necessary compliance forms and obtains patient signature as required for regulatory agencies.

Interacts with physicians, physician’s office staff to secure diagnosis, procedure details or authorization information.

Performs patient registration activities to ensure accurate financial and biographical data and documentation have been obtained and properly entered into hospital records.

Completes insurance processing; including account creation, insurance verification, notification, and authorization functions.

Updates and distributes information regarding patient demographics including insurance information.

Obtains required information from patients, other departments and physicians, as needed; communicates with patients or designated other parties regarding financial responsibility and collects payment for the same, if applicable.

Communicates and interfaces with hospital personnel, patients, medical staff, and family members to ensure high-quality patient care.

Updates, compiles, and distributes information regarding patient demographics including insurance information.

Documents all notification, authorization and eligibility information in the registration systems, uses electronic verification tools and web-based resources.

Contacts insurance carriers by telephone for appropriate billing information such as authorization numbers, eligibility and benefits;

documents all activity and additional information in host system.

Maintains appropriate filing systems, records, reports, and confidential files to ensure quick retrieval.

May prepare daily deposit and reconcile daily batch.

Adheres to TMCH organizational and department-specific safety and confidentiality policies and standards.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION : High School diploma or General Education Degree (GED), or an equivalent combination of relevant education and experience.

EXPERIENCE : Three (3) years of medical office and / or hospital experience to include six months healthcare eligibility and benefit analysis or scheduling experience for diagnostic testing and / or surgery.

Applicants must have basic computer familiarity and experience.

LICENSURE OR CERTIFICATION : None required.

KNOWLEDGE, SKILLS AND ABILITIES :

Knowledge of office management practices, including billing and scheduling within healthcare.

Ability to read or listen and comprehend simple instructions, short correspondence, and memos.

Ability to write simple correspondence; ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

Ability to read and interpret documents such as safety rules, procedure manuals, and regulations.

Ability to effectively present information and respond to inquiries or complaints from patients and / or their representatives and the general public.

Ability to interpret and explain insurance benefits and patient financial responsibility.

Ability to operate basic office equipment, including familiarity with computer use.