FINANCIAL COUNSELOR

HILLSIDE INC•Atlanta, GA

18h

About The Position

The Financial Counselor is responsible for verifying health insurance benefit coverage for prospective and existing Hillside clients. The Financial Counselor will provide excellent customer service while collecting monies owed to Hillside through insurance out-of-pocket as well as self-pay expenses. The Financial Counselor will carefully project the amounts owed by Hillside’s clients and review the breakdown of these cost estimates with the financially responsible party. Key to the Financial Counselor role is clearly informing parents and/or guardians of the amount due prior to admission, then applying insurance company payments and actively monitoring patient accounts throughout the service delivery period. As discrepancies arise, the Financial Counselor is responsible for proactively resolving all financial issues with the designated financially responsible party, prior to and subsequent to the client’s discharge from Hillside services.

Requirements

Excellent oral, written and interpersonal communication skills are required
Ability to provide excellent customer service is required
Ability to perform basic math is required (addition, subtraction, multiplication and division; solving word problems/equations)
Proficiency in Microsoft Office is required; experience with Electronic Health Record systems is preferred
Attention to detail is required
Ability to work independently is required (driven, self-directed)
Ability to work as part of a team is required
Excellent organizational skills are required
3 years of relevant experience is desired

Nice To Haves

Bachelor’s degree preferred

Responsibilities

Completes health insurance benefit verification for clients admitting to Hillside
Verifies the eligibility of the prospective client for the identified program track, as well as other program tracks offered by Hillside
Based on the benefit quote from the insurance representative and web database(s), estimates the financial responsibility for the prospective client
Documents the verification of benefits and the estimated financial responsibility, utilizing the designated forms and saving them in the designated locations
Shares pertinent information with appropriate parties internally (i.e. confirming coverage, noting non-coverage / exceptions / exclusions, etc.)
Reviews and collects estimated financial responsibility from prospective clients
Reviews the estimated financial responsibility (i.e. Out of Pocket costs) with the financially responsible party
Collects payment for the entire balance estimated to be owed
Sets up payment plans upon request, following established processes
Creates customer statements and accounts
Each day, runs admissions report from Hillside’s Electronic Health Record
Creates client statement in Excel and client account in accounting software for each admitted client
This responsibility will remain until Hillside has completely transitioned to running all client accounts out of the Electronic Health Record
Resolves insurance benefit issues that arise during or after services
When notified about a coverage or benefit issue (i.e. lapse in coverage, coordination of benefits, etc.), intervenes to resolve the identified issue with the financially responsible party
Shares pertinent information with appropriate parties internally
May include: Admissions, Billing, Utilization Review, Revenue Cycle Specialist, and others as needed
Reverifies benefits and collects additional payments, as needed
Verifies benefits prior to a client transferring from one program to another within Hillside, ensuring that the client has the correct benefit before services begin
Follows up with the responsible party regarding additional payment, when relevant
Collects payment and answers questions, as needed
Communicates internally regarding any potential barriers to collecting payment
Verifies benefits as needed to confirm active coverage for current clients
Collects payment from clients transitioning to self-pay
Collaborates with the clinical team and follows up with clients potentially transitioning to self-pay to accomplish the following:
Reviews self-pay costs with the family, including the first day self-pay costs apply
If the client is transitioning to self-pay:
Obtains signed self-pay form (and files appropriately)
Collects payment and manages payments until discharge
Keeps the clinical team informed as to the status of outreach to the family (i.e. the family has paid for x number of days of self-pay; the family refuses to pay for self-pay; the family has not responded to outreach attempts; etc.)
Proactively manages client account balances
Reviews client accounts following admission
Collects payments as needed
Issues refund requests when appropriate
Communicates with families regarding account balances, following established procedures
Proactively works through aging reports
Reviews client accounts following discharge
Tracks discharges daily
Compares amount collected with accrued charges (and likely additional charges)
Tracks until resolution (all claims processed / account at zero balance)
Tracks last paid and last covered dates
Coordinates with other departments to ensure all relevant information is obtained that may impact client accounts
Contact families to collect balance prior to discharge, if applicable
Serves as the primary contact for all account inquiries
Responds to all inquiries from families regarding client accounts
Coordinates as needed internally to resolve account issues
Codes payments from clients daily
Codes payments arriving through Square, Waystar and online portal
This responsibility will remain until Hillside has completely transitioned to running all client accounts out of AVATAR
Manages failed Payment Plans
Reviews Waystar monthly for failed payment plans, as well as when the Finance Department sends over a failed payment plan notice/email.
Pulls updated Waystar benefit, reviews the client’s dates of service and statement to verify if claims have been posted. If not, sends request to Finance Department to review claims.
If payment plan is still needed, contact responsible party to collect/edit payment plan. If unable to reach responsible party within 24 hours, the client will be passed to the Finance Department for collections.
If payment plan is no longer needed (Out of pocket max has been met), payment plan will be cancelled and passed to the Finance Department, if refund needed.
Assists with projects in the Admissions department, as needed