Financial Counseling Representative - Lindner Center of HOPE - Full Time, Days

Job Description

The Financial Counseling Representative is responsible for interviewing patients or their representative for the purpose of determining patients' financial eligibility for a variety of medical assistance programs. The Representative is also responsible for collecting estimated patient liability such as deductibles and co-payments at preadmission and/or point of service.

Responsibilities

Financial Assessment:
  • Interviews patients or their representative in person or by telephone using RAMP to obtain financial and other eligibility data and assists patients in completing applications.
  • Verifies accuracy of demographic and financial data and updates systems as needed.
  • Obtains signatures for various Federal, State, and/or Local assistance programs.
  • Assists the patient when necessary in completion of the application(s) to include doing the required reading, writing, and/or explanation of the document(s) and/or required verifications.
  • Analyzes financial and eligibility data and reviews length of disability to determine potential eligibility for Federal, State and County programs; completes the necessary documents within the time limits specified by the appropriate government agency.
  • Determines the patient's ability to reimburse the hospital; interviews and corresponds with patients, responsible relatives, attorneys, employers, agencies, and insurance companies to obtain, verify or clarify information.
  • Reviews prior account notes and uses established methods to obtain information that might aid in the application process or establish there is existing third party coverage.
  • Updates system(s) as required with demographic information, account/guarantor notes, third party updates, etc..
  • Determines and manages proper course of action for optimal reimbursement of healthcare charges (i.e. Spend Down eligibility, Cobra coverage, etc.)
  • Decides on appropriateness and refer specific accounts to the Financial Counselor, Eligibility Vendors, County Department of Job and Family Services, etc.

Program Eligibility:
  • Analyzes financial applications along with income/resident documentation in order to determine the best way to assist the patient.
  • Refers qualifying accounts to the Financial Counselor for possible linkage to Medicaid or federal disability programs.
  • Obtains and distributes (with proper authorization) medical records for Medical Eligibility determinations and litigation.
  • Researches and provides patients with information in order for them to make decisions regarding their insurance coverage and provider of care.
  • Documents all follow-up activity in the hospital financial system.
  • Monitors the pending accounts by using the Financial Counseling ONTRAC worklist to assure that follow-up takes place as required.
  • Communicates difficult or unusual account matters to the Supervisor for assistance.

Reimbursement/Collection:
  • Follow-up for collection of payments for deposits, settlements, payment arrangements, out-of-network settlements, specialty services (i.e. cosmetic, obstetrics, oral surgery, etc.)
  • Maintains current knowledge of collection and fair debt practices.

Miscellaneous:
  • Attends seminars and courses on relevant topics (i.e., Medicare, Medicaid, Government HMO's, Hamilton County Tax Levy Regulations, and OHCAP regulation).
  • Educating affected areas to apply information accordingly for compliance of program regulations.
  • Obtains interpreters, (either verbal or sign language) for patients. for non English speaking or deaf patients. I
  • nteracts cooperatively with Patient Relations and Risk Management to resolve patient issues.
  • Maintains effective communication and cooperative working relationships with other department, staff, and members of medical staff, patients, and visitors.


Qualifications

Education: High school diploma or GED.

Experience: Prefer minimum 2 years' experience interviewing public regarding applications for financial assistance in health care setting.

Required Skills and Knowledge: Knowledge of federal and state Medicaid laws and regulations, Social Security disability and supplemental security income disability requirements. Microsoft Word and Excel preferred.