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University of Rochester Maternity Financial Counselor - 233513 in Rochester, New York

Maternity Financial Counselor Job ID 233513

Location Strong Memorial Hospital Full/Part Time Full-Time Favorite Job Regular/Temporary Regular Opening

Full Time 40 hours Grade 010 Financial Counseling&Outpt Reg

Responsibilities

POSITION SUMMARY:

Coordinates all aspects of patient financial account management for Mother and Newborn Inpatient admissions. Responsible for obtaining and/or confirming newborn insurance information, legal name and pediatrician’s name. Completes the tasks of insurance verification, obtaining and/or verification of pre-certification requirements, responsible for collecting self pay balances including non-covered services. Responsible for the follow-up on Medicaid Pending newborns and knowledge of hospital's Financial Assistance policy. Responsible for both accounts from admission until the final bill is produced.

This role may have the option to work a hybrid-remote schedule and communicate daily through virtual meetings.

SUPERVISION AND DIRECTION EXERCISED:

Performance on assigned tasks is monitored against departmental standards. May train and coordinate activities of peers or other staff as assigned by management. May work in a self-directed team.

MACHINES AND EQUIPMENT USED:

Standard office equipment, including but not limited to: telephone, pneumatic tube system, CRT/PC, printer, photo copier, fax, EPIC, Outlook, and third-party verification terminals.

ESSENTIAL DUTIES:

Customer Interaction - 10%

Creates a professional and effective customer-oriented environment by utilizing excellent communication skills to obtain demographic, insurance information and all required signatures for payment of hospital services and to assist with follow-up care. (I.e. Discharge planning).

Financial Management - 70%

  • Reviews each Maternity admission for insurance history by utilizing the hospital system along with RTE or all third-party payer systems.

  • Obtains service-specific benefits and coverage; looks into pre-certification requirements and tracks the approval process, offers ways to secure additional financial resources (e.g. applying for baby’s not on policy, limited coverage, new born benefits, Medicaid and/or Financial Assistance) and coordination to patients/families early and often when possible.

  • Identifies and confirms self-pay patients and those with financial hardship for appropriate referral to Financial Case Management for possible Medicaid application and /or Financial Assistance for all Maternity levels of care and adding insurance, if found.

  • Knowledge of state law requirement for length of stay of 48 hours for normal delivery or 96 hours for cesarean. Monitors the admission for undelivered, complications, and extended stays to notify the payers.

  • Notifies parents of 30 day window for completing the paperwork through employer group to add the baby to either moms and/or dads policy. Establish and maintain mutual payer relations for the addition of the newborn baby which can take up to 6-8 weeks of case review. The NICU population are tracked even after discharge until the baby is added to the mothers or fathers policy, sometimes both which then the third party payer regulations for the coordination of benefit rule needs to be followed.

  • Obtains baby legal name and troubleshoots with legal name discrepancy, DOB issues, gender mismatch, missing PCP, and incorrect effective dates for their newborn and NICU cases.

  • Notifies Birth Certificate Office of all Medicaid and Medicaid Managed Care auto-eligible newborns.

  • Identifies and notifies patients of COBRA entitlement and assist with paperwork if necessary.

  • Monitors the discharge list for babies transferred to our NICU for notification of transfer to third party payers.

  • Notifies Utilization Management of clinical requests by third party payers and requests for NICU leveling.

  • Informs clinic and physicians offices of completion of sterilization forms and tracks the form in eRecords.

  • Accountable for meeting department standards for completion and QA of visits on a day to day bases by utilizing workqueues, registration checklist, and FC stop bills.

  • Oversees Highcost NICU babies to obtain and track the approval process. Collaborates with parents, Social Work, and Patient Accounts for any financial risks or insurance coverage issues. Documents timely updates according to policy.

  • Communicates with NYSOH to correct auto-eligible newborn coverage discrepancies.

Quality Management- 20%

  • Consistently monitors current admissions to ensure eligibility and additional clinical requirements.

  • Notifications of admission to third party payers are after the 48/96 hours guideline.

  • Observes discharged visits on the workqueue list daily for potential cases that may require notification to insurance companies.

  • Monitors NICU babies until added to policy.

  • Monitors Highcost babies for discrepancies, barriers, and clinical requirements.

  • Checks Medicaid eligibility every 30 days for active coverage.

  • Notifies Provider’s office of sterilization form for compliance.

  • Attends educational programs for the department at the Manager's direction.

  • May train or perform other duties assigned by management.

QUALIFICATIONS:

AAS in related discipline (admitting/registration/patient billing/insurance) with 3 years of related experience, preferably in a hospital setting, or an equivalent combination of education and experience. Requires a high degree of professionalism and motivation with excellent written and verbal communication and customer service skills; ability to work independently as well as in a team environment; highly collaborative; self-starter; strong computer skills and ability to type 45 words per minute. Prefer medical terminology. Certified Application Counselor (CAC) required. Flexible to work other assigned hours and/or responsibilities as needed.

NOTE: This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

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