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University of Rochester OBH Financial Counselor - 226601 in Rochester, New York

OBH Financial Counselor Job ID 226601

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

Full Time 40 hours Grade 009 Financial Counseling&Outpt Reg

Responsibilities

POSITION SUMMARY:

The Financial Counselors assesses all aspects of patient financial account management for all visits on any urgent; emergent; preadmission; and ambulatory level. The Financial Counselors are accountable for coordinating all activities necessary to financially secure the defined case load through the verification process; resolving complex problems that include but not limited to pre-certifications; Utilization Management; coordination of benefits; baby not on policy; Cobra entitlement; Medicare Life Time Reserve days; and Medicare Advantage issues. Involves inĀ­ 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 Counselors are ultimately responsible for minimizing any delays from admission until the final bill is produced.

SUPERVISION AND DIRECTION EXERCISED:

Responsible for monitoring own performance on assigned tasks. Self-directed and must make complex decisions independently. May train other support staff.

MACHINES AND EQUIPMENT USED:

Standard office equipment, including but not limited to: telephone, page system, pneumatic tube system, personal computer, printer, photo copier, fax, and third party verification systems.

TYPICAL DUTIES:

Customer Interactions - Essential 10%:

Creates a professional and effective customer oriented environment by utilizing excellent communication skills to obtain pertinent demographic information; confirms insurance information; discusses financial obligation; confirms with unit secretary patient agreement signature on file; documents demographic and insurance information in a timely, accurate manner in the hospital computer system following department and hospital standards.

Financial Management - Essential 75%:

  • Reviews each visit for insurance history by utilizing the hospital system along with all third party payer systems.

  • Obtains benefits; pre-certification requirements and/or completes notification of admissions.

  • Identifies and confirms self-pay patients for appropriate referral to Financial Case Management for possible Medicaid application and/or Financial Assistance.

  • Identifies pre-existing conditions during the insurance verification process for lapse or creditable coverage.

  • 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 inpatient stay.

  • Accountable for meeting department standards for completion and QA of visits on a day to day bases by making sure missing registration items are complete and authorization obtained.

Quality - Essential 15%:

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

  • Notifications of admission to third party payers are within the 24-48 hour guideline.

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

  • Ensures Medicare compliance with the Office of the Inspector General guidelines by notifying patients of exhausted Medicare benefits and the option of utilizing their lifetime reserve days.

  • Monitors the ALC report for any level of care changes and ensure there is coverage.

  • Reviews Medicare for MSP questions and validation.

  • Checks Medicaid eligibility every 30 days for active coverage.

  • 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. 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. Prefer medical terminology. Flexible to work weekends, 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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