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Wellstar Health System · 5 hours ago

Financial Counselor E&E RC - North Fulton, Kennestone, Spalding

Roswell, GA

Full-time

Onsite

Entry, Mid Level

2+ years exp

Wellstar Health System is dedicated to enhancing the health and well-being of every person they serve. The Financial Counselor E&E RC role focuses on assisting patients with Medicaid eligibility and enrollment, ensuring compliance with regulations, and enhancing the overall patient experience.

FitnessHealth Care

Responsibilities

Collects the estimated financial responsibility for current services as well as any outstanding guarantor balances, regardless of patient class at the earliest possible collection control point

Monitors in-house accounts and makes financial arrangements with guarantors for payment of their full financial responsibility prior to discharge

Communicates with Medicaid Eligibility Vendor to determine eligibility and approval/ denial status, as needed. For discharged referrals, contact by phone or letter within 10 days of referral

Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities

Identifies those patients without adequate insurance coverage. Makes personal contact with guarantor to determine guarantor's ability to pay non-covered charges, as well as to determine potential eligibility for financial assistance programs. (i.e. Medicaid)

Maintains a list of health care financial assistance programs and the eligibility requirements for each program. Refers patients/guarantors to sources of outside funding assistance, distributes financial assistance (i.e. Medicaid) applications as needed

Works efficiently and accurately within designated time frames to ensure a continuity of information and cash flow

Interviews guarantors at time of registration, or at least within 24 hours of admission, to verify complete insurance and financial information. Explain financial options,and collect the estimated financial responsibility

Documents concise and understandable notes regarding all collection activity, as well as each patient or guarantor interaction. Documents all efforts to collect guarantor account balances, other self-pay collection activities and referrals to Medicaid

Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency Registration, Utilization Review, Nursing, Social Services, and Patient Financial Services

Verifies insurance coverage and benefits

Consistently meets or exceeds department productivity standards. Formally reports results of collection activity to direct supervisor, daily or according to policy. Provides feedback to PAS management concerning collection and data integrity issues

Responsible for completion of appropriate errors and issues in Workqueues

Reviews daily census and/or applicable workqueues and visits hospital patients when appropriate, verifies patient coverage, benefits, and collects estimated patient liable amounts

Interviews each patient or representatives to obtain complete and accurate demographic, financial and insurance information

Obtains all necessary signatures and is knowledgeable regarding any special forms that may be required by the patients third-party payer

View charges to determine financial estimates and collects appropriate co-pays/ and or deductibles

Makes corrections and updates patient account information in computer

Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes

Maintains a working knowledge of available information system capabilities and performs all system applications that are required

Understands and applies WHS philosophy and objectives, and WellStar and any departmental. policies and procedures, as related to assigned duties. Understands the admission, outpatient and emergency registration process

Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations

Consistently demonstrates the ability to organize work

Recognizes and establishes appropriate work priorities and completes work in a productive manner

Maintains proficiency in data entry skills

Assists with Medicaid screening on all accounts

Resolves errors in assigned Workqueues

Greets all guest with a positive and professional attitude

Answers incoming phone calls and follows through with requests made

Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other professional contacts, and the public. Demonstrates ability to tactfully handle difficult situations

Presents a well-groomed and professional image in coordination with dept/ hospital dress codes

Uses appropriate telephone etiquette and scripting

Is flexible with work hours to meet department needs

Meets service recovery and customer service guidelines

Stays current and conveys knowledge of various insurance plans to customers as needed

Works well with Team Members and understands appropriate department process

Identifies and requests additional information as needed to complete authorization requests

Adheres to scheduled work hours and provides proper notice of absences, tardies and any other work schedule changes

Cross-trains in all areas of registration

Attends departmental meetings at the request of WellStar Management

Completes all required and/or mandatory training

Maintains multiple login credentials to utilize various tools to access third-party and insurance web portals for insurance verification and precertification processes

Performs other duties as assigned

Qualification

Medicaid regulationsInsurance verificationEpic Electronic Health RecordFinancial counselingData entryCustomer serviceMicrosoft Office SuiteVerbal communicationWritten communicationActive listeningOrganizational skills