Financial Counselor
Eastern Maine Healthcare Systems
 Brewer, ME

Job Details

SUMMARY OF MAJOR FUNCTION

The primary function of the Financial Counselor is to ensure a constant and reliable cash flow, maximize revenue collections, minimize Accounts Receivable losses (bad debt) using all follow up work tools. Financial Counselor (FC) is responsible to ensure all accounts passing through FC Unit are screened and all appropriate actions are completed. Employees must work independently and interview patients, families, care managers, physicians and others to resolve accounts. The FC must have a solid understanding of their role in the revenue cycle.

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ESSENTIAL FUNCTIONS AND WORK ROLE RESPONSIBILITIES

  • Protects privacy and confidentiality by:
  • Not discussing (PHI) protected health information in public areas
  • Conducting all communications, interviews and telephone conversations with customers in a private setting
  • Keep all patient PHI confidential
  • Accesses clinical and financial information on a need-to-know basis ONLY.
  • Delivers Excellent Service by:
  • Providing a comfortable atmosphere for customers
  • Using telephone etiquette
  • Giving directions to customers / accompanying them if necessary to their location
  • Exhibit Commitment to Co-Workers by

Conducting him/herself as professional and treats others with respect, courtesy and sensitivity. Recognizes each person as a part of the team and as a professional who brings value to their area of expertise.

  • Maintains and collaborates with all other hospital departments by phone, message and in person to resolve problems, obtain additional information to ensure accurate billing information.
  • Training:

a. Completes all required trainings i.e. HealthStream / Fire Training

  • Keep abreast of all third party billing changes, internal office

changes, and any changes in other hospital departments that are

pertinent to Patient Financial Services by reading material and

attending meetings to maintain cash flow on a timely basis.

  • Serves as mentor for new employees and cross training
  • attend Payor meetings / EMHS System meetings as requested
  • Utilizes systems / Carrier Portals available to verify eligibility and benefits.
  • Protect the hospital's cash flow interests by assisting patients in verifying or calling for them to obtain re-authorization/certification for hospital admissions and out-patient surgeries.
  • Establishes appropriate payment arrangements:
  • Pursues all other payment sources
  • MaineCare

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  • COBRA
  • Healthcare Marketplace
  • Negotiates payment in full or offer time payments according to the Inland Billing and Collections Policy
  • Screens accounts for Financial Assistance or payroll deduction, by interviewing the patient and requesting the completeness of a written application.
  • Performs “Authorization Proofing“ following up on all Surgical and high dollar Out Patient Services to be sure that we have received the appropriate authorization from the referring provider.
  • Performs and participates in the Appeals Process for claims that were denied by insurance carriers for claims that did not meet the Authorization Requirements per the insurance carriers.
  • Perform Financial Assistance Needs Analysis for Self-Pay patients at the POS to investigate all funding sources. (ie deposit and payment terms, COBRA eligibility, Healthcare Market Place, MaineCare or Disability or complete a Free Care Application)
  • Interview Self-Pay patients while they are in-house or at the time of pre-op testing.
  • Verifies personal information and tries to determine if any insurance exists.
  • Interviews new admissions within 24 hours of receipt of admission. Counsels and advises patients of payment terms according to established guidelines. Requests patients to remit deposit upon discharge, handles pre-admission interview in the same manner.
  • Answers incoming telephone calls.
  • Answers telephone calls within the first three rings by identifying the department and person answering.
  • Responds to inquiries immediately or directs patient to the proper area by establishing the proper patient name.
  • Responds to voice mail by the end of the business day or by the next business day.
  • Accepts and appropriately posts cash from customers.
  • Posts payment to the appropriate system
  • Provides receipt to the customer
  • Files facility copy of the receipt for end of day tying.

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  • Performs additional responsibilities usually associated with the job title within the incumbent's training limitations.

PHYSICAL ENVIRONMENT

Work is performed in a tight work space and at times in a stressful atmosphere (phones ringing, patients requiring answers to questions, cashing checks, etc.)

PHYSICAL CRITERIA/EFFORT

Work involves sitting 70%, walking and standing 20% and lifting 10%. Hearing and vision acuity constantly required. (Repeated bending, squatting and stooping)

OCCUPATIONAL RISKS

Failure to follow established procedures could result in slips and falls or back injury from stooping and lifting.

PROBABILITY AND CONSEQUENCES OF ERRORS

Errors could result in loss of income to the hospital.

NUMBERS SUPERVISED

This is a non-supervisory position.

MINIMUM REQUIREMENTS FOR THE JOB

EDUCATION

Associates degree or other technical college education or the equivalent in work experience and continuing education.

EXPERIENCE

1-2 years in a medical setting “preferred“

1-2 years work experience with Customer Service

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SPECIAL KNOWLEDGE REQUIRED

  • Verbal and written aptitude for adequate communication with the general public, physicians, office staff, Registration Staff and other Healthcare Professionals.
  • Must demonstrate the ability to work well with others and to work independently without direct supervision.
  • Must exhibit Excellent Customer Service skills
  • Must have the ability to handle multiple priorities successfully
  • Position requires close attention to detail.
  • Must present in a professional manner
  • Typing skills of 35 wpm with a general working knowledge of Windows and Microsoft Office.