Financial Counselor, Patient Access - St. Peter's Hospital - FT Rotating Shift
About The Position
Purpose Financial advocate for the patient and a liaison between Revenue Site Operations (RSO) and Patient Financial Services (PFS). Determines liability on patient accounts and works with patients or their representatives to provide financial assistance or secure payment. Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Work Focus: Researches, collects & analyzes information. Identifies opportunities, develops solutions, & leads through resolution. Collaborates on performance improvement activities as indicated by outcomes in program efficiency & patient experience. Responsible for distribution of analytical reports. Process Focus: Utilizes multiple system applications to perform analysis, create reports & develop educational materials. Incorporates basic knowledge of TH policies, practices & processes to ensure quality, confidentiality, & safety are prioritized. Demonstrates knowledge of departmental processes & procedures & ability to readily acquire new knowledge. Data Management & Analysis: Research and compiles information to support ad-hoc operational projects & initiatives. Synthesizes & analyzes data & provides detailed summaries including graphical data presentations illustrating trends & recommending practical options or solutions while considering the impact on business strategy & supporting leadership decision making. Leverages program & operational data & measurements to define and demonstrate progress, ROI & impacts. Maintains a working knowledge of applicable Federal, state & local laws/regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects safe, honest, ethical & professional behavior & safe work practices. Functional Role (not inclusive of titles or advancement career progression Provides patient counseling regarding treatment costs, insurance coverage, available payment resources, and financial assistance options. Secures and documents payment arrangements. Submits authorization for initial and subsequent high-cost infusion and oncology services based on complex treatment plans. Coordinates with the patient, physician, insurance company, and pharmaceutical company to complete the required pre-authorization process. Validates payable diagnosis codes/medical necessity and prior therapy requirements according to FDA and NCCN guidelines. Assists patients in financing, payment plans, financial assistance and all financial options through the organization. This includes grants, co-pay assistance for high-cost pharmacy/drugs and free-drugs for infusion and specialty care patients. Monitors assigned patient accounts through entire revenue cycle to ensure copay program claims, payments, denials, and other assistance programs are being processed properly. Assists with ordering, tracking, and reporting of all free drugs obtained. Collaborates with the treatment team on the financial implications of medical intervention to the patient and the health care provider. Responsible for case management of complex financial clearance needs for patients and elevates cases as appropriate. Works closely with RSO and division leadership to improve collections.
Requirements
- High school diploma or GED.
- Minimum two (2) to three (3) years experience working in Patient Access or Patient Accounting for hospital registration and / or hospital reimbursement services
- Obtain National certification in HFMA CRCR and/or NAHAM CHAA required within one (1) year of hire.
- Understanding of basic billing and coding.
Nice To Haves
- Bachelor's degree or advanced certification or a combination of advanced training and/or certification (e.g., Registered Nurse, Licensed Practical Nurse, Certified Pharmacy Technician, Registered Health Information Technician, or medical coding certification through AHIMA or AAPC
- Epic experience preferred.
- Knowledge of federal or state government agencies including but not limited to Medicare, Medicaid, VA or Charity Care programs, or patient management and healthcare accounts receivable within the healthcare revenue cycle.
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What This Job Offers
Job Type
Full-time
Industry
Religious, Grantmaking, Civic, Professional, and Similar Organizations
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
