Duties:To assess patient financial needs, assist patients and collect deposits according to the Client Hospital Billing and Collection Policy in a professional and courteous manner.
To screen patients and assist with applications for applicable governmental programs, the health insurance exchange, and/or the Client Health financial assistance program.
To stress customer service and positive interpersonal relations while working closely with Admitting/Registration, Preauthorization, Care Management, appropriate department personnel in Patient Financial Services and MCW Clinical Practice Services in addressing financial responsibilities.
Other duties as assigned.
- For patients who are identified as self pay, claim financial hardship or the inability to pay, initiates timely account resolution activities to address the issue while attempting to allow elective patient care to proceed as scheduled.- Monitors applicable Financial Counselor work queues to ensure that all initial patient financial activities have been completed, and that account balances that have not been previously secured through insurance verification or other confirmed subsidy sources are addressed in a timely manner.
Reviews Financial Counselor work queues on an ongoing basis to ensure payment source has been secured for all discharged self pay patients when applicable.
Updates the patient accounting system as activities have been completed and as patient account problems and issues have been addressed, in accordance with Patient Financial Services policies/procedures.
- Counsels with patients to guide them through the application and eligibility process with Medicaid offices, Victim of Crime, Insurance Exchange, and other resources available to patients to cover Client Health services.
- Assists patients with the Financial Assistance application process according to the protocols set forth in the Client Health, Community Physicians, and Medical College of Wisconsin Financial Assistance policies.
- Based on the patient's ability to pay and the urgency of medical need, collects patient deposits after estimating the approximate costs of the anticipated care. Calculates, provides, and updates estimates upon necessity to various staff and patients.
- Calculates, provides, and updates estimates upon request to various staff, patients, and other potential customers.
- Communicates with Social Services, Case Management, Admitting/Registration, appropriate department personal, and the physician as applicable to discuss those patient financial problems that cannot be resolved to determine the alternatives to the elective patient care plan.
- Enforces hospital patient accounting and compliance processes by confirming that required documents have been completed, insurance (re) verification has been performed, and precertifications/re-certifications have been obtained.
- Cross trains and provides backup coverage for all Financial Counselor positions as determined by the Team Coordinator or Patient Financial Services Manager to ensure adequate Financial Counselor coverage for all areas within department.
This includes shifts extending into the PM shift and weekend or holiday coverage.
- Assist patients during open enrollment period to apply for a Qualified Health Plan (QHP) and/or Insurance Affordability Programs.
- Adhere to document storage & destruction policies/procedures.
- Adhere to all state and federal regulations along with Client policies/procedures pertaining to the Certified Application Counselor responsibilities.- Stay current on all regulatory updates and policy/procedure changes pertaining to Certified Application Counselors at Client Health.
Skills:One year of experience in healthcare/revenue cycle functions (or other business office), case management, or social work is required.
Experience using Microsoft Word, Excel and other software programs is preferred.
Experience using Epic in a healthcare environment is preferred.
Experience in social work or case management is preferred.
Education:High School diploma or equivalent is required.
Bachelor's degree in social work, case management, healthcare administration, business administration, or other related field is preferred.State of Wisconsin and Federal Certified Application Counselor Designation is required or must obtain within six months after hire.
Certifications & Licenses:Stay current on all regulatory updates and policy/procedure changes pertaining to Certified Application Counselors at Client Health.
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Last updated on Sep 16, 2022