Patient Financial Coordinator

Job description

Overview

The Patient Financial Coordinator - Certified Application Counselor assesses patients' financial and insurance information in order to determine Medicaid, Marketplace, other Community Resources or UPH Financial Assistance Program as option of last resort. Facilitates the actual insurance enrollment processes. Manages accounts that require a detailed, large scope analysis of payment/insurance options in order to secure reimbursement. Handles active, unbilled, self-pay and high dollar inpatient and outpatient accounts. Receives account referrals from Pre-access Department, Utilization Review Staff, Patient Access Staff, Physicians, Central Business Office Managers and others for high deductible, out-of-pocket expenses, unresolved or pending claims, and other financial risk issues. Counsel's patients that have previous debt, with poor payment history, are unresponsive or uncooperative in implementing appropriate payment solutions.

Interacts in a professional and compassionate manner to ensure patients and their representative's needs are met and that they understand the hospital's financial policy, through various payment and/or insurance options. Increases Unity Point Health staff communications, accuracy, productivity, cohesiveness, and continuity system wide, while improving direct communications with the Central Billing Office regarding patient's financial obligations. Creating a position that allows us to assist our patients with all of their financial needs by providing a "one stop shop" experience. Increases patient satisfaction by reducing duplication of efforts and not having them referred to another employee(s) to get the same results. Incorporates all Unity Point Health Clinics, Urgent Care and Express Cares to provide them with the best financial options as we engage, enroll, and educate together.

Responsibilities

Patient Financial Coordinator/Certified Application Counselor

* Counsels patients via phone or in person, reviews patient's previous accounts for outstanding balances, and financially counsels them on all options of payments.
* Monitors and works, on a daily basis, all self-pay accounts from the assigned work queues.
* Assess patient's financial/insurance information in order to determine insurance eligibility.
* Gather financial data to complete initial assessment.
* Follow up with Department of Human Services and all other Public Agencies regarding application progress.
* Reviews Department of Human Services decisions for enrollment in applicable states.
* Ensure that all follow-up with the Department of Human Services has been completed for and by the patient.
* Assess patient/consumers for other Community Assistance Agencies.
* Ensure that every self-pay patient apply for Medicaid, and all options have been exhausted, prior to the patient qualifying for Financial Assistance.
* Tracks financial impact of PFC/CAC Program.
* Works closely with the CBO to ensure that there is cohesiveness of processes and no duplication of efforts.
* Communicates effectively with Case Managers to impact their plan of care.
* Educate patients, employees and physicians regarding Medicaid and Marketplace place insurances that may be available.
* Possesses excellent time management skills to ensure that patients being discharged are counseled, prior to handling other less "time sensitive" responsibilities.
* Maintains billing and collection tracking spreadsheets that captures patients and account disposition/resolution.
* Completes and submits Medicaid and/or ACA Applications for patients that may potentially qualify in a timely and accurate manner.
* Educates consumers/patients on Quality Health Plans, deductible, out-of-pocket, government subsidies, etc.
* Maintains, extensive and current, knowledge of Marketplace plans with Iowa and if appropriate Illinois, Nebraska, Wisconsin exchanges.
* Completes annual CAC Training for UPH as well as CMS. Displays all Certificates, at all times, when assisting consumers in office or in person.
* Provides fair, impartial, accurate information to assist consumers when submitting the eligibility application for a quality Health plan thru Healthcare.gov online or via phone.
* Assists Registration in maintaining a working knowledge of a patients Medicare life time reserve days. Provides patient education as needed.
* Facilitates Medicaid patient's documents for non-universal charity eligibility sent to the CBO.
* Explains payment options, UPH collections processes and accepts payments directly from our Inpatients and all patients from both the Hospital and Clinic locations.
* Assists patients in completing UPH Financial Assistance Application and forwards all appropriate documents to the CBO.
* Documents actions in all appropriate computer systems. Documentation must be thorough and include current account disposition and direction of future activities.
* Performs follow-up and maintains all assigned work que accounts.
* Updates patient's Medicaid information in Epic and communicates changes to appropriate parties.
* Facilitates Cobra account appropriateness.

Qualifications

Education/Certifications:

* Associates Degree in a health-related field.
* Bachelor's degree in related field preferred.
* CMS Marketplace Certified Application Counselor Certification or obtain within 12 months of hire date
* DHS Presumptive Certification or obtain within 12 months of hire date.
* Complete all Online DHS enrollment access and certifications for appropriate states or obtain within 12 months of hire date

Experience:

* 5 years of healthcare experience in related area.
* Experience and knowledge in completing and submitting Medicaid and Marketplace applications desirable.

Skills:

* Knowledge of Medical Terminology preferred. Strong computer skills required.
* Ability to perform a variety of tasks, often changing assignments on short notice.
* Must be adept at multi-tasking.
* Will be required to learn and work with multiple software/hardware products (sometimes concurrently) during an average workday.
* Must possess excellent communication skills, verbal and listening.
* Must be able to maintain a professional demeanor in stressful situations.
* Adept with technology typically found in a business office environment.
* Able to build productive relationships with all contacts.
* Must be able to perform data entry with speed and accuracy.