University of Rochester Financial Coord - 219861 in Rochester, New York
Strong Memorial Hospital
Full Time 40 hours Grade 009 Financial Counseling&Outpt Reg
The Financial Counselor assesses all aspects of patient financial account management for nursing home stays. The Financial Counselor is accountable for coordinating all activities necessary to financially secure the resident's account through the verification process; requesting deposits for non-covered services and co-pays; resolving complex problems that include but not limited to prior authorizations; notifying Utilization Review of clinical requested; coordination of benefits; Cobra entitlement; Medicare SNF covered days; and Long term care issues. Involves in-depth communication; collaboration; and follow-up with patients; families; third-party payers; governmental agencies; employers; social work; financial case management; and utilization management. The Financial Counselor is ultimately responsible for capturing accurate insurance information to minimize revenue delays.
Creates a professional and effective customer oriented environment by utilizing excellent communication skills to review demographic information; confirm insurance information; discusses financial obligation; updates demographic and insurance information if applicable in the nursing home computer system following nursing home standards.
Reviews referrals for appropriate insurance coverage by utilizing the nursing home system along with all third party payer systems.
Obtains nursing home benefit information and prior authorization requirements if applicable.
Identifies and confirms self-pay patients and/or need for assistance with co-pays and deductibles for appropriate referral to Financial Case Management for possible Medicaid application and /or Financial Assistance for hospital charges.
Completes LDSS-3559 for each individual event i.e. Admission; change in status; discharge and
forwards to appropriate Local Department of Social Services; NYS exchange and/or Medicaid Managed Care Plan/Medicaid Long Term Care Plan.
Notifies and monitors patient's COBRA entitlement and assists with paperwork if necessary.
Determines the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits.
Notifies Utilization Management of clinical requests by third party payers.
Maintains a monitoring system for adequate benefit coverage and eligibility throughout the Resident's stay.
Accountable for meeting nursing home standards to meet facility, state, local and federal regulations.
Manage Census Activity (admissions, discharges, payer source changes)
Consistently monitors resident's insurance coverage to ensure eligibility.
Knowledge of Medicare's nursing home guidelines and limited coverage.
Attends the Current house meeting and monitors the current house report for any level of care changes and ensures there is coverage.
Reviews Medicare for MSP questions and validation.
Attends educational programs regarding compliance at the Manager1s direction.
May train or perform other duties assigned by management.
Reviews roster for Medicaid recertification.
High school diploma and 4 years of related hospital credit services experience or Bachelor's degree in Business Administration, Health Care Administration, Psychology, or related discipline and 1 year of related experience; or equivalent combination of education and experience. Medical terminology required.
Require high degree of professionalism and motivation with excellent communication and customer service skills; strong computer skills and ability to type 25 words per minute. Strong knowledge of Medicare, Medicaid and HMO processes. High comfort level to meet with residents/families. Flexible to work weekends, other assigned hours and/or responsibilities as needed.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled