Financial Counselor - Full Time - $17.92 - $20.62/DOE/Benefits

As a Financial Counselor you will evaluates and secures the health care benefit status of each patient, utilizing the demographic, financial and clinical information supplied by the Patient Registration Department, patient interviews, and consultation with other departments and outside agencies to ensure maximum reimbursement to the physicians and hospital in a timely manner.
Some duties and responsibilities include the following:
o Complies with established departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards.
o Maintains effective communication with hospital staff, physicians, physician's offices, and patient and/or families.
o Demonstrates knowledge and utilizes computer system and its features.
o Identifies uninsured/underinsured during the course of the hospitalization; determines alternative sources of revenue; acts as a financial resource to patient and patient families.
o Verifies insurance benefits for inpatient admits and notifies review organizations of hospital admission in compliance with contractual agreements.
o Verifies health insurance coverage for each admission prior to discharge.
o Utilizes Code Correct to determine if requested outpatient procedures are covered by Medicare, and if not obtains signed ABN notifying patient of their responsibility. Also contacts physician office to identify possible other procedures that would be covered by Medicare.
o Works closely with billing department in maintaining the Financial Assistance spread sheet.
o Verifies all scheduled outpatient procedures to ensure they are not on the CMS Inpatient Only List.
o Follows through in obtaining missing admitting demographic and financial information not captured at time of admission to the hospital, then accurately documents into the hospital's information system.
o Pursues and secures appropriate payor authorization, if required.
o Explains financial requirements to patient and collects deposits and deductibles as required.
o Coordinates closely with the Case Management and Social Service Departments regarding patient needs and/or payor requests.
o Assists in educational training of Patient Registration staff to ensure appropriate skills and payor knowledge for correct patient registration.
o Will be responsible for following-up with all Trauma patient accounts to ensure and appropriate payor source has been identified.
o Maintains and updates knowledge regarding managed care or other related issues.
o Verifies all demographic and financial information has been obtained for all scheduled medical or surgical admissions and authorization has been secured prior to admission, if required.
o Reviews and verifies all demographic and financial information for all unscheduled medical or surgical admissions and obtains appropriate authorization, if required, within twenty-four hours of admission.
o Understands, supports, promotes, and adheres to the customer service philosophy and standards of the Tahoe Forest Hospital District.
o Demonstrates System Values in performance and behavior.
o Complies with System policies and procedures.
o Other duties as may be assigned.
Associate's degree (A.A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience. Bachelor of Arts Degree highly desirable. One to two years experience working with public and experience in patient registration and/or hospital patient accounting office preferred.
OTHER EXPERIENCE/Qualifications:
Strong aptitude with Microsoft Access is highly desirable.

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