Financial Counselor

Financial Counselor

Reporting to the Manager of PFS, the Financial Counselor works with patients and / or their representatives to resolve patient account issues, develop payment plans and secure payments. Effectively screens patients for compliance with payer requirements and corrects and updates accounts to bill appropriate parties. Ensures patient information needs are met, and that they understand the hospital's revenue cycle expectations including resolution of personal liabilities through various payment options. Assists customers with the financial assistance application process. Researches historical cases in the hospital's utilization software system to develop cost estimates for out-patient and inpatient services.

Location : Glenview, IL

Full Time

Hours : Monday-Friday, 8am 4 : 30pm

What you will do :

• Communicates with patients and their representatives, physicians and their office staff, employers, and ancillary departments to accurately collect and review all required demographic, insurance / financial, and clinical data necessary to expedite payment on patient accounts.
• Receives and reviews all inpatient admission and outpatient services self-pay accounts received from ancillary departments / physicians to determine if a significant deductible or payment is applicable. Interviews and consults with potential customer walk-in / telephone inquiries and physicians requesting written estimates for inpatient or outpatient services.
• Conducts research in the hospital's utilization software system searching for comparable historical cases to determine self-pay account liability and to construct written estimates for potential customers and physicians considering NCH for services. Enters variable case elements in the utilization system entering specific demographic and service parameters to drill down and target appropriate case cost comparisons. Consults with Decision Support department resources on requests for complex estimates or when limited utilization data exists. Prepares written estimates for customers and physician's offices based on information provided.
• Obtains required financial information from patients including identification of payment sources and reviews financial assistance options. Assists patients with completion of financial assistance applications including a review of bank and financial statements, tax returns, pensions, retirement and stock funds; requests additional information, approves or denies applications, performs write-off within department policy.
• Negotiates and secures initial co-payments. Communicates hospital policies and establishes payment arrangements with patients per hospital and financial assistance policies and procedures. Follows the Health Insurance Portability and Accountability Act (HIPAA), payer and applicable regulations and standards for registration and billing. Verifies patient financials are complete by ensuring benefits have been approved and received, and that co-pays and deductibles are paid. Formulates an agreed upon payment plan prior to outpatient services or inpatients being discharged from the hospital.
• Collaborates with NCH patient financial services and medical records staff, physician's offices and insurance carriers to research and adjudicate outstanding patient account balances and refunds. Conducts follow-up telephone calls to patients / guarantors regarding outstanding self-pay account balances. Explains account balances, payment policies and secures payment arrangements within hospital collection policies or financial assistance options. Sends follow-up letters to patients regarding status of account and issue resolution and generates mailings for all accounts that do not have a completed Medicare Secondary Payer questionnaire for hospital adherence to Center for Medicare & Medicaid Services (CMS) guidelines.
• Maintains work queues, performs necessary tasks to complete the account which may include, use of activity codes, notification and follow-up with patient via phone or written correspondence, follow-up with 3rd party payers, research within Patient ID and / or credit rating software to manage NCH accounts receivables and meet timely filing or other payer and contractual requirements.

What you will need :

Benefits (For full time or part time positions) :

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE : Race / Color / Sex / Sexual Orientation / Gender Identity / Religion / National Origin / Disability / Vets, VEVRRA Federal Contractor.