Financial Counselor

Financial Counselor

I. Job Summary / Job Purpose

The Financial Counselor assists patients by providing information to patients who require assistance navigating through their financial options.

II. Key Responsibilities

• Provide information to patients on costs, payment methods and alternatives to payments, including charity care.
• Work with clinic staff to proactively identify patients with potential need for financial assistance.
• Counsel patients on billing processes, hospital and clinic statements and availability of financial assistance.
• Document financial arrangements for future care.
• Provide answers to reimbursement questions regarding health-plan eligibility, benefit issues, co- pay requirements and medical referral requirements.
• Receive and process charity care and/or financial assistance applications.
• Work with health insurance providers to determine coverage and benefit limits.
• Prepare estimates of procedures, calculates payments requirement, and informs patient of acceptable payment arrangements on balance, both current and previous.
• Verify financial information to determine insurance coordination of benefits, pre-certification/prior authorization requirements.
• Explain alternative medical financing and assists in completion of applications and/or contracts in order to meet patient needs while assuring maximum reimbursement.
• Perform other duties as assigned

III. EngageMED Core Expectations

At EngageMED, we expect all our employees to live the values of Integrity, Innovation, Respect, and Service at work by:

• Honoring and caring for the dignity of all persons in mind, body, and spirit
• Ensuring the highest quality of care for those we serve
• Working together as a team to achieve our goals
• Improving continuously by listening, and asking for and responding to feedback
• Seeking new and better ways to meet the needs of those we serve
• Using our resources wisely
• Understanding how each of our roles contributes to the success of EngageMED.

IV. Core Job Competencies

Core EngageMED Behaviors: The following behaviors have been identified as critical to all staff roles at EngageMED:

• Teamwork Orientation: works cooperatively & collaboratively with others toward the accomplishment of shared goals.
• Service Orientation: desire to serve and focus ones efforts on discovering and meeting the needs of internal and external customers.
• Achieves Results: reflects a drive to achieve and outperform. Continuously looking for improvements. Accepts responsibility for actions and results.
• Learning and Growth: has a commitment to continuous professional and organizational learning
• Communication: practices attentive and active listening and can restate opinions of others; communicates messages in a way that has the desired effect.

Role-Specific Behaviors: these additional behaviors are necessary in the role:

• Knowledge of clinic financial options, payment alternatives and insurance billing/authorization requirements
• Knowledge of federal and state payor requirements, including Medicare, DSHS, HMO/PPO Contracts.
• Knowledge of the meaning and usage of medical terminology, abbreviations and coding protocols (e.g./ ICD-10) sufficient to perform the duties of the position.
• Strong analytic, organizational, communication and interpersonal skills.
• Demonstrated knowledge of accounting, credit and collection laws and fundamentals, and current insurance and government financial assistance programs and regulations.
• Possess a strong work ethic and a high level of professionalism.
• A team player who handles multiple projects simultaneously in a fast paced environment.

Skills, Knowledge or Abilities critical to this role:

• Language Ability: Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to common inquiries or complaints from groups of managers, clients, customers, and the general public.
• Math Ability: Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
• Reasoning Ability: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• Computer Skills: Must be proficient with the Microsoft Office Suite, Internet navigation, database management, desktop publishing, spreadsheet, and graphic presentation packages.

V. Job Requirements / Qualifications

1. Education / Accreditation / Licensure (required & preferred):

• High school diploma or equivalent required.

1. Experience (required and preferred):

• 2 4 years related experience required.

VI. Disclaimers

• This job description reflects EngageMEDs assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned.
• Critical features of this job are listed above. They may be subject to change at any time due to reasonable accommodation or other reasons.