The Financial Counselor serves as Gritman Medical Center’s primary contact for patient reimbursement issues in accordance with established credit policies. The individual in this role is responsible for screening and enrolling uninsured and underinsured patients for external assistance programs, with a primary focus on Medicaid. This individual is also responsible for assisting patient in the process of completing financial assistance applications, educating them about their financial responsibility, and helping them identify a path toward resolving their balance. Depending on the need, this individual may meet with patients in the hospital and/or clinic, at the bedside or chair-side. This role involves communicating with patients both in person and over the phone, and requires a high level of customer service. All communications are conducted in a manner that will result in positive patient relations and prompt reimbursement for services.

Customer Service: Identifies customer groups and assesses their service needs. Meet and exceed customer needs in a caring, efficient and cost-effective manner. Customers are treated with respect in a polite and professional manner and all requests and inquiries are handled promptly.

Quality: Maintain levels of quality of service/product which meets or exceeds customer expectations through demonstrations, contributions, and continuous Quality Improvement by participation in C.Q.I. training, understanding of performance requirements, mistakes and omissions are made with less than 5% error rate and errors are resolved quickly, and employee works willingly with instructors/coordinator to correct performance deficiencies.

Participates in the review and revision of professional standards and complies with established professional standards. Maintains confidentiality of patient and employee information. Engages in personal conduct at work that is legal, ethical and moral, dependable, and reliable. Develops and maintain skills, knowledge and abilities required for adequate performance of assigned job duties. Seeks opportunities to improve substandard performance and takes direction and corrective action in a positive manner and demonstrates improvement.

Bills Accounts (5%): Establishes correct payor and address, requests and obtains required information (medical records, progress notes, accident information), reviews for accuracy of codes (revenue, CPT, and diagnosis) according to payor, reviews bills and insurance forms for discrepancies, and sends bill to payor, within three (3) days of computer generation or follows up with department of person information requested from.

Provides Customer Service (95%): Answers phone within three (3) rings, provides assistance and accurate answers to customers, researches patient complaints with involved department, responding to patient with satisfactory resolution within one (1) week or providing update to patient and continue researching, make payment arrangements and assist patients in applying for county assistance or Medicaid if unable to pay. Research non-payment of insurance, attend county hearings and appeal denials, go to patients room at discharge and go over insurance benefits and give estimate of their portion owing. Offer 15% discount for payment before leaving or make payment arrangements. Make collection calls on past due accounts before going to collection, report payments on collection accounts and financial companies and pull credit bureau reports. Follow any job-related instructions and perform any other job-related duties requested by the supervisor/director.

Minimum Work Experience
Minimum of three years of appropriate work experience that would indicate a high level of communication skills and organizational ability
Financial counseling, eligibility screening, and/or Medicaid application processing experience strongly desired
Prior experience performing community outreach preferred

Screen and enroll uninsured and underinsured patients to identify potential financial assistance opportunities.

Assists patients in enrolling in other programs, such as Medicaid, County Medically Indigent Services Programs, or other scholarship programs, as needed.

Ensures financial assistance applications are accurately filled out and completed

Processes financial assistance approvals and denials, prepares accounts for posting functions

Processes bankruptcy notices, provides requested information to legal representation, collection agencies, etc.

Works in conjunction with on-site Case Managers to assist in the appropriate completion of Medicaid applications, ensuring this funding source is maximized, based on patients’ eligibility

Helps patients develop a plan to resolve their liabilities, including setting patients up on payment plans according to Gritman Medical Center guidelines

Collects monies from patients with the ability to pay, including outstanding accounts receivable

Educates patients by providing explanations of common terms (e.g., co-pay, coinsurance); their billing statements to prevent confusion; and any other questions patients may have about this financial responsibility

Stays informed of statutes and regulations that could affect the collection of receivables (e.g., collection regulations)

Completes daily administrative tasks as necessary, such as filing, scanning, processing paperwork, and documenting interviews with patients

Complies with federal, state, and organizational standards to ensure patient privacy is protected at all points of a financial inquiry process

Builds professional and technical knowledge by attending and completing organizational training

Attends meetings as requested

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.

Provides a positive and professional representation of the organization.

Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.

Maintains hospital standards for a clean and quiet environment.

Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.

Participates in ongoing quality improvement activities.

Maintains compliance with organization’s policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.

Complies with organizational and regulatory policies for handling confidential information.

Demonstrates excellent customer service through his/her attitude and actions, consistent with the standards contained in The Gritman Way.

Population Served
Adult and geriatric. All genders, race, ethnic, sociopolitical, demographic, marital and sexual preference groups, developmental and physical abilities, religions, and nationalities.

Environmental Conditions
Location: Inside.

Minimal risk of exposure to blood borne diseases and biohazardous materials.