APR Consulting · 4 hours ago
Patient Financial Care Counselor
Durham, NC
Contract
Onsite
Entry, Mid Level
$22.50/hr - $22.50/hr
2+ years expAPR Consulting, Inc. is a leading Healthcare Staffing Provider in the United States, currently seeking a Financial Care Counselor. The role involves managing patient access activities in the emergency department, including patient registration, insurance verification, and financial counseling to ensure compliance and enhance the patient experience.
ConsultingCRMHuman ResourcesInformation TechnologySmall and Medium BusinessesStaffing Agency
Responsibilities
Correctly identify patient by checking an approved photo ID and utilizing a minimum of three approved patient identifiers (Patient name, Date of Birth, Last four of Social Security # or Home Address). Follow Red Flag procedure for patients unable to identify / verify. Arm band patient as required
Verify, capture, and update demographic information to include name, address, phone number, emergency contact, guarantor, race, ethnicity, veteran status, employer, primary care provider and / or referring provider in Maestro Care as needed. Ensure all information is accurate and complete
Verify, capture / update insurance information; determine and select insurance carrier, enter subscriber information and plan information. Maintain proficiency in verifying insurance eligibility and obtain benefits via all methods (e.g. integrated vendor eligibility solutions (RTE), phone, fax, or payer website)
Verify with patient on any Worker’s Compensation-related encounter to determine financial liability and obtain any / all accident-related details. Coordinate registration and billing for covered services and update all liability information in Epic. Follow-up with Hospital Service Access management when appropriate
Review / resolve eligibility edits, coordination of benefits, data mismatch, and content errors prior to or at time of service. Appropriately document in medical record
Capture and appropriately document patients with special needs, for example risk for falls, bariatric, short of stature, etc. Communicate with clinical staff and correctly align special needs fields with any ambulatory documentation conflicts to minimize risks and meet joint commission standards
Inquire with patient if an interpreter is needed at time of service and complete applicable fields in MaestroCare. In conjunction with the Americans with Disabilities Act (ADA), coordinate an interpreter when requested through Interpreter Services and utilize Service Hub as appropriate
Present and educate patients on financial, compliance, and authorization forms. Obtain all necessary signatures or E-Signature as required per policy. (For example, Conditions of Admission/Treatment -COA/COT, Medicare Secondary Payer Questionnaire -MSPQ). Appropriately label, scan, or e-sign and document to medical record for retention. Modify communication to ensure patient understanding if necessary
Prospectively address patient financial responsibility. Identify and collect patient financial liabilities (copay, coinsurance, deductibles, account balance); post appropriately based on payment type, payment amount and method of payment
Identify additional funding opportunities to safeguard patients and Duke. Explain Financial Assistance policy to patients. Complete Medicaid screening questions for self-pay patients. Set up payment plans and address all questions and concerns; appropriately refer to customer service if unable to answer the questions
Provide education, generate enrollment codes and support / encourage MyChart enrollment. Identify and assign appropriate proxy in accordance with state and federal regulations to minimize inappropriate medical record access
Set patient expectations; round in waiting room to ensure a positive patient experience. Address concerns with patient; involve clinical leadership as needed
Balance and close cash, check, and credit card collections at the end of each day; reconcile discrepancies and prepare personal deposit according to cash management policies
Meet Private Card Industry (PCI) standards by securing cash and credit card receipts at all times during hours of operation, following policy for obtaining and return of cash bags on daily basis
Obtain Imprest cash bag at the beginning of the shift. Complete Imprest cash bag logs, void refund logs, and receipt book logs (as needed) to meet internal control standards
Resolve system-warning messages related to registration items (for example verification of patient coverage, review of guarantor information for billing / collections, and confirmation check list items) to ensure compliance with billing and safety regulations
Completes all work according to procedures and standards. Achieve registration quality expectations to meet key performance indicators related to timely billing, collections, patient experience and safety initiatives
Safeguard sensitive information to maintain confidentiality and in adherence to HIPAA guidelines
Assist in the specific Trauma arrival process and policies in the DUH ED
Responsible for Decedent Care workflow, verifying Death Certificate, flowsheets, and maintain accurate records on the release of expired patients in the DRH ED
Maintain a knowledge of insurance company requirements by reviewing payer websites, reading payer updates provided by Payer Relations and Service Access, and by attending Service Access monthly education sessions. Apply knowledge to identify potential process changes when new services are offered within service area
Communicate with physicians and medical staff to obtain clinical information required for scheduling a referral as needed
Participate in research to reverse denials or prevent future denials. Provide feedback to Service Access Manager and/or Team Lead regarding trends in user errors or system errors. Offer recommendations for improvement
Communicate (e.g. fax, phone) with insurance carriers regarding information requested upon arrival and resolve issues relating to coverage and payment for specific patient populations. (i.e. Veteran’s, International)
Serve as a resource for case management, social work and utilization management in identifying patient coverage for future plan of care
Schedule and coordinate walk-in with the appropriate service line per scheduling guidelines, utilizing questionnaires as appropriate where applicable. Ensure appointments are scheduled with correct providers and in the proper order to respect referring provider and patient preferences to achieve efficiency during the patient visit
Correctly link the study orders or referral with the appropriate study, encounter or appointment
Provide patient with appropriate visit instructions to include any necessary locations, times, provider, practice information, and financial responsibility for next appointment
Achieve scheduling quality expectations to meet key performance indicators to maximize reimbursement, minimize denials and promote a positive patient experience
Follow Financial Pathway guidelines when scheduling (Out of network, self-pay, Out of County self-pay and Medicaid) ensuring patient education for financial responsibility and payment expectations
Prioritize and complete work residing in claim edit, patient, and order work queues based on criteria set by Service Access leadership to maximize patient flow. Resolve registration (100 level) billing claim edits related to both the technical (HB) and professional (PB) work queues
Serve as an expert in the reconciliation of registration and authorization related billing edits and errors that prevent claims filing. Provide routine feedback to Service Access Manager and/or Team Lead regarding trends in user errors or system errors. Offer recommendations for improvement
Assist in the collection of data, as needed, which facilitates improvement opportunities in the insurance verification and patient billing processes
Actively participate / engage in process improvement initiatives to maximize workflow efficiency, patient, experience and safety
Achieve or exceed patient experience expectations by remaining helpful, professional and responsive to patient needs. Consistently use “Commitment to Service Excellence”, “Words that Work” and “RELATE” in daily interactions
Ensure internal and external customer(s) needs are a primary focus in one’s actions at all times; develop and sustain productive customer relationships
Always present oneself in a way that is consistent with Duke’s values and behaviors. Treat others fairly and with respect while protecting the dignity, integrity and rights of each person
Using the approved service recovery guidelines while maintaining composure, determine the best course of action related to patient or area concerns and escalate as appropriate
Inform clinical staff of late arrivals and identify appropriate action (for example arrive and reschedule if necessary.)
Provide directions, arrange for patient transport, and interpreters as necessary
Comply with all regulatory and compliance policies and procedures, understand and follow Joint Commission guidelines
Actively engage in the work culture initiatives of the area. Be respectful and considerate of others’ point of view and embrace the diverse backgrounds of all within the organization
Assists and supports fellow employees in their work to commit to overall organization success
Accept accountability and ownership for all actions and behaviors that impact personal and organizational performance. Demonstrate a climate of trust by acknowledging own mistakes and taking responsibility for one’s action
Answer incoming calls in a timely and professional manner. Identify and address caller needs or transfer to the appropriate area that will meet the needs of the caller
Maintain printers, copiers and workstations. Report technical and / or service issues to management in a timely manner
Attend and participate in staff meetings, huddles and in all required education sessions
Ensure a safe environment for patients and staff; report personal and patient safety concerns to area leadership, as well as incident reports within 24 hours of occurrence
Maintain Mass Casualty training and protocol in the event Hospital Incident Command System (HICS) is initiated
Perform other duties as assigned by area leadership
Perform Downtime related procedures
Handle admission and outpatient-related functions after hours when applicable departments are closed
Maintain proficient knowledge on the Release of Information policies, responsible for emergent requests when HIM department is closed
Qualification
Required
High School Diploma (minimum), Associate degree in clerical accounting preferred
Minimum of two years experience working in hospital patient access, a physician office or billing and collections; or one year of experience working with the public and an associate's degree in a healthcare related field or one year working with the public and a bachelor's degree in a health care related or non-related field
Ability to work on foot for up to 12 hours to perform bedside registration
Ability to engage with patient suffering various physical traumas
Company
APR Consulting
APR Consulting is a nationally recognized, award-winning provider of talent acquisition and workforce solutions, helping organizations simplify, scale, and optimize their operations.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Aaron Stone
Chief Operating Officer
Recent News
Staffing Industry Analysts
2023-12-24
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