Financial Counselor

DRISCOLL HEALTH PLAN•Corpus Christi, TX

1d•Onsite

About The Position

This position is for a Financial Counselor at Driscoll Children’s Hospital, where compassion meets innovation and technology. The role reports to the Patient Access Services Manager and is responsible for support functions vital to the department's objectives. These functions include patient accounting, insurance and patient account follow-up, variance reconciliation, coordination of benefits, reimbursement verification, and appealing denials. Driscoll Children’s Hospital is a 191-bed tertiary care center serving 31 South Texas counties, offering 32 medical and 13 surgical specialties. Combined with its non-profit Health Plan, Driscoll Health System emphasizes core values of Compassion, Advocacy, Respect, Excellence, and Stewardship, applied across all positions. The hospital focuses on providing advanced medical treatments and technologies with a compassionate approach to children.

Requirements

High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience
Knowledge, skill, and/or ability required to perform essential duties satisfactorily

Responsibilities

Maintain utmost level of confidentiality at all times
Adhere to hospital policies and procedures
Demonstrate business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines
Adhere and comply with customer service standards and dress code as set forth by the hospital and the department
Answer the department telephone immediately or within three rings utilizing courtesy and patience
Greet patients and their families with courtesy and concern for their needs
Listen to customer needs and take appropriate action as indicated
Document telephone encounters
Work with outside collection vendors to resolve account issues as indicated
Financially screen patients for medically needy program as assigned
Follow up with patients as necessary to finalize medically needy determinations
Document HHSC determinations and update patient accounts as indicated
Resolve any billing issues to ensure appropriate reimbursement that is expected
Review patient demographic and financial data to ensure accuracy
Validate payer information is accurate and in the correct billing order for accurate reimbursement
Work to resolve disputes between the insurance subscriber or member and their insurance company
Manage denial appeals as indicated
Create and maintain referral records and group to Auth cert records within EPIC
Review patient accounts to ensure proper policy and processes are followed
Identify patients with multiple same day visits to combine accounts when applicable
Review and validate billing process to ensure Federal and state guidelines are followed
Review and validate cashier process to ensure appropriate reconciliation
Verify and document insurance eligibility and coverage for anticipated procedures
Work with clinical case management to identify accounts or payers that are not reimbursing appropriate to the authorization