Financial Counselor I

Stanford Health Care•Palo Alto, CA

1d•$34 - $39

About The Position

The Financial Counselor Level 1 screens uninsured and underinsured patients at bedside and before or after services to identify government or charity programs that may cover medical expenses. The role conducts patient financial interviews, reviewing hospital charges, insurance status, and financial resources, and may complete applications and follow up on their approval. It also determines financial clearance for visits or referrals, checks eligibility and benefits, confirms authorization requirements, assesses the risk of uncleared cases, estimates out-of-pocket costs, and handles payments securely and accurately. The counselor completes registration and admitting processes and works to address patients’ financial concerns in accordance with Stanford Health Care policies and procedures. The role requires professional communication with patients, families, case workers, social workers, medical center staff, physicians, and leadership. The employee is expected to meet productivity goals and manage complex, changing needs with sound judgment, attention to detail, and professionalism. Through on-the-job and/or formal training, employees at this level are expected to acquire the skills and qualifications needed to advance to Financial Counselor II.

Requirements

High school diploma or GED equivalent.
At least 1 year of progressively responsible experience in hospital or clinic financial counseling.
Knowledge of pre-authorizations and reimbursement regulations pertaining to Medicare, Medi-Cal, and children's health programs.
Previous experience working in a metrics-based environment driven by financial counseling goals, such as screening rates and collection goals.
Strong knowledge of eligibility and enrollment requirements for Medicare, Medi-Cal, Workers' Compensation, managed care (HMO, PPO, POS, etc.), and children's health programs (CCS, GHPP, Healthy Families, etc.).
Experience resolving issues in financial reimbursement billing, utilization management, and government programs.
Experience calculating, communicating, and educating patients about their financial responsibilities.
Demonstrated communication, customer relations, and organizational skills.
Ability to multitask with attention to detail.
Ability to complete work efficiently and solve problems independently.
Ability to work well in a team environment.
Proficiency, as applicable, with Epic, insurance websites, point-of-service payment systems, and web-based screening tools.
Knowledge and understanding of Microsoft Word, Excel, and PowerPoint.

Nice To Haves

Bilingual in English and Spanish.

Responsibilities

Find solutions to address patient financial needs in accordance with Stanford Health Care policies and procedures.
Determine financial clearance for a patient's visit or referral before or at the time of service; check eligibility and benefits and determine whether authorization requirements have been met.
Assess the risk of cases that have not been financially cleared or secured before service, clear low-risk cases, and escalate high-risk cases to a coordinator or manager.
Contact patients about steps required to clear appointments for services, including collecting deposits for their financially responsible portion.
Estimate patients' out-of-pocket costs quickly and accurately and prepare documents presenting those costs for payment.
Handle payments collected at the point of service securely and record them accurately.
Use problem-solving skills to address patients' concerns and needs.
Communicate professionally, orally and in writing, with patients, case workers, social workers, hospital directors and executives, Patient Financial Clearance and Patient Access Services staff, medical center staff, physicians, and guests.
Manage multiple tasks and handle complexity and stress as patient, family, and health system needs change.
Meet weekly individual productivity goals and standards while following priorities set by the Team Manager or coordinators.
Perform other duties as assigned by the unit team manager or Patient Financial Clearance management personnel.
Complete the registration and admitting process from start to finish.