Public Resource & Financial Counselor - Self Pay Rev Cycle - Sharp Mesa Vista Hospital - Full Time - Day Shift

Sharp HealthCare•San Diego, CA

1d•Onsite

About The Position

Perform in-depth financial analysis of individual's financial status for the purpose of evaluating the individual's eligibility for public funding. Assist the underinsured and uninsured patients in securing governmental, commercial and/or private funding to cover healthcare costs. Works in collaboration with physicians, social workers, and case managers with discharge planning needs. Educates patients on healthcare options and resources. Determine and educate the patient of their financial liabilities, collect any amounts owed, and oversee the financial investigation to identify payment sources and possible alternatives.

Requirements

Driver's License - CA Department of Motor Vehicles -REQUIRED

Nice To Haves

H.S. Diploma or Equivalent
3 Years experience in a health care system revenue cycle.
Previous social work or case management experience.
California Notary Public - California Secretary of State -PREFERRED
Covered CA Enrollment Counselor certification preferred.
Utilizes reliable transportation and possesses adequate personal insurance coverage.
Demonstrates clean driving record in accordance with requirements of the employer DMV pull notice program and Sharp HealthCare Driver Guidelines.
Strong knowledge of Federal, State and County Programs preferred.

Responsibilities

Perform in-depth financial analysis of individual's financial status for the purpose of evaluating the individual's eligibility for public funding.
Assist the underinsured and uninsured patients in securing governmental, commercial and/or private funding to cover healthcare costs.
Works in collaboration with physicians, social workers, and case managers with discharge planning needs.
Educates patients on healthcare options and resources.
Determine and educate the patient of their financial liabilities, collect any amounts owed, and oversee the financial investigation to identify payment sources and possible alternatives.
Provides direction and assistance to patients requesting financial assistance.
Demonstrates content expertise by completing applications and supporting documents for programs including but not limited to: MediCal, Medicaid, CMS, CMSP, SSI-Disability, Victim of Crimes Compensations, COBRA, and Health Care Exchange Qualified Plan Enrollment.
Identifies all unfunded admissions and completes face to face interview and application within 24 hours of admission.
Manages patient expectations for assistance through effective communication and interaction.
Performs field visits in support of the public resource application process.
Receives a listing of locations to be visited from the Self Pay Rev Cycle Team Lead.
Plans their daily route based on level of urgency and geographic location.
Completes the objective listed and reports back results.
Uses technology in the field to provide timely update and improve efficiencies.
Ensures PHI being transported is safe by adhering to departmental guidelines.
Reports mileage and expense reports daily.
Ensures responsibility utilization of organization resources and technology including: mobile telephone device and/or laptop.
Utilizes electronic databases to identify a patient's projected out of pocket responsibility.
Ensures continuity of care by building relationships with Sharp affiliated and community physicians.
Maintains open communication and feedback to maximize the use of health care resources to members of the community.
Provides timely communication to the assigned social worker/case manager regarding the status of application.
Determine the patient's financial liabilities.
Works collaboratively with PAS Payor Focus Department to determine insurance benefits.
Identify patient responsibilities and apply the Financial Toolkit to resolve a patient's out of pocket expense.
Utilizes databases managed by the Department of Health and Human Services and/or Department of HealthCare Services.
Completes required documentation in GE/Centricity HPA application.
Updates demographic insurance documentation.
Reviews supporting documentation provided by patients for accuracy.
Ensure information submitted to databases is accurate and processed timely.
Submits supporting documentation timely (within 24 hours) to appropriate public program.
Works in partnership with County assigned Health and Human Services Representative (HHS) to ensure timely processing and determination of all submitted applications.
Performs a thorough follow up process on all submitted applications as required such as: identify cases for appeal opportunity, prepare appeal paperwork with patient, attend hearings; ensuring attainment of healthcare coverage.
Liaison between patient and public resource program staff.
Works with hospital Social Work and Case Management departments to safely discharge patients by ensuring the public resource application process is on track.
Uses effective interviewing skills to elicit patient application for funding information.
Maintains knowledge of Sharp contracts to include but not limited to PPO, HMO, and State Health Insurance Exchange qualified health plans.
Provides direction and assistance to all self-pay portions of the patient's receivables.
Maintains knowledge of Federal Poverty Limits.
Maintains knowledge of Fair Debt Credit Protection Act, Sharp Healthcare Financial Assistance Programs, Payment Options, and discount policies.
Presents the patient with the best option for their situation.
Works with the manager to determine other payment/discount options on a case-by-case basis.
Uses effective interviewing skills to elicit patient application for funding information.