ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Financial Counselor is responsible but not limited to complete and accurate patient registration, verifying/authorizing insurance benefits, collecting patient responsibility. Obtaining and accurately entering into the computer system patient or guarantor demographics and insurance information along with the proper coding. He/she is responsible for financial counseling the patient/guarantor for the optimal resolution of the patients account according to the patient’s insurance requirements, collections of payment, charity review or referring the patient for eligibility determination. He/she is responsible for collecting out of pocket expenses from patients/guarantors that have the ability to pay. Continuous monitoring of department schedules to ensure financial requirements are met prior to patient’s arrival.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Other duties may be assigned.
· Obtain and enters accurate patient demographics, financial information and codes for a complete registration for patients scheduled for services.
· Ensures insurance benefits are verified and authorized prior to services. Determine if information provided is applicable for services requested i.e.: workers comp, liability, levels of Medicaid eligibility and specific policy benefits. If applicable reports any issues with obtaining authorization prior to services to Lead, Supervisor or Manager (paging appropriate person if unavailable by phone or in person).
· Evaluates patient/guarantors financial status (insured or self-pay) to determine the patient/guarantors financial responsibility.
· Counsels patients/guarantor to determine their ability to pay. Counsels patients/guarantor to determine financial hardship/charity. Offers self-pay discount or refers patient for assistance with eligibility vendor if eligible.
· Collects co-pays/co-ins/deductibles, deposits, private room and self-pay balance. Either prior to services, walk-in services or inpatients.
· Comprehend insurance information and verification/authorization process. Knowledge to navigate via internet or phone contact to determine insurance coverage and benefits, authorizes, verify services and confirm patients/guarantors insurance information and responsibilities.
· Maintains knowledge of policy and procedures related to resolution of patient’s accounts i.e. self-pay discounts, charity policy, internet web sites or phone contact to insurance for determining patient’s responsibility.
· Maintains knowledge of the revenue cycle to include billing process and patients/guarantor options along with understanding managed care agreements.
· Review accuracy of work performed correcting errors assuring accuracy of info obtained and work processes documenting appropriately in the patient account notes. Meets or exceeds the departments pre-determined productivity standards.
· Works with physician’s office staff to obtain and provide information necessary to obtain authorization for services.
· Documents detailed and specific information in patient account notes for reference to work performed.
· Provides estimates using applicable tools for patients for physicians as requested.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
· High School Diploma or GED required.
· Minimum of 1 years of experience in a combination of excellent customer service skills and financial counseling or cash collections preferred.
· Intermediate computer knowledge: Uses Microsoft Word, Excel, Outlook, and Windows
