Clinic Based Financial Counselor

Job Description

Job Description

ORGANIZATION INFORMATION :

Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV / AIDS, lesbian, gay, bisexual, transgender, and queer / questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around : primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV / STI prevention, advocacy, and community health initiatives.

SALARY : $42,500-$53,100

BENEFITS :

PTO

Vision

Dental

Health

401k

Sick time

POSITION SUMMARY :

The Financial Counselor who will be responsible for the timely and accurate financial counseling of uninsured or underinsured patients. They will assist patients and persons of the community in understanding their financial coverage and costs, identifying uninsured or underinsured patients in need of financial assistance and assist the patient in applying for Ohio Medicaid, the Health Insurance Exchange Marketplace, Equitas Health’s Financial Assistance Program or other relevant programs.

ESSENTIAL JOB FUNCTIONS :

Essential functions of the job include, but are not limited to, sorting, utilizing a computer for data entry, conducting research, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets and coordinating multiple schedules. Communicating with others is an essential job function.

MAJOR AREAS OF RESPONSIBILITIES :

• Counsel patients regarding the resources available. Utilize the Medical assistance / Financial Assistance Screening tool with patients when applicable.
• Assist uninsured or underinsured patients with obtaining health care coverage with either the Health Insurance Exchange Marketplace or Ohio Medicaid.
• Assist persons of the community with Health Insurance Exchange Marketplace or Ohio Medicaid enrollments via the Connect to Care referral process.
• Coordinating Ryan white and Patient assistant program intervention (PAPI) enrollment
• Identify patients who qualify for assistance through programs including Ryan White, provide program education and refer accordingly for enrollment assistance.
• Assist patients living with HIV afford services by administering the sliding fee scale and monitor patients’ cap on charges.
• Assist patients with other methods of financial counseling, i.e., explaining insurance benefits, requesting price estimates, and setting up payment plans.
• Identify patients who qualify for sliding fee and assigning sliding fee copays.
• Work with patients who are experiencing a hardship in filling out a hardship application. Gather the required documentation.
• Manage and update expired hardship applications to ensure compliance of the 6 month eligibility.
• Monitor the various work lists and work queues to ensure the appropriate follow-up within the expected time periods. Resolve complex outstanding patient issues.
• Conduct daily review and analysis of accounts flagged for review.
• Assist with inquiries via walk-in or phone patients regarding billing problems (i.e. Sliding Fee and Ryan White) in conjunction with the department’s counseling services.
• Perform benefit education and financial counseling on potential out of pocket expenses for patients who have services scheduled.
• Provide resources as applicable and requested to patients and persons of the community.
• Assist with the Connect to Care referrals providing financial counseling and coverage assistance.
• Overlap with other departments (i.e. Care Team, Prevention Health Navigation, Pharmacy and Health Advocacy) coordinating health care needs.
• Maintain compliance with quality standards.
• Adhere to Equitas Health Confidentiality Policy.
• Perform other duties as assigned.

EDUCATION / LICENSURE :

• High School diploma or equivalent and 2 years’ Medical experience.
• Insurance coverage and billing experience.
• ACA / Marketplace certified and Ohio Department of Insurance (ODI) licensed or within the first 30 days of employment.

Knowledge, Skills, Abilities and other Qualifications :

• Proficient with Microsoft Office (Access, Excel, Word and Outlook), accounting software, and other applications
• Experience with EPIC or other Medical Software is a plus.
• Strong PC and computer skills required.
• Excellent organization skills with an ability to prioritize and manage multiple tasks and a variety of demands and work efficiently without constant supervision.
• Must have sensitivity to, interest in and competence in cultural differences, HIV / AIDS, minority health, sexual practices, and a demonstrated competence in working with persons of color, and gay / lesbian / bisexual / transgender community.
• Work well under pressure and ability to be flexible. Team player with strong communication and interpersonal skills.
• Ability to document and assess client’s linguistic needs and identify resources needed to enhance communication.
• Ensure participant confidentiality.

OTHER INFORMATION :

Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE / AA