Job Information

Providence Patient Financial Counselor, Days, Onsite in Medford, Oregon

Description

Providence St. Joseph Health is calling a Patient Financial Counselor to work remotely within our footprint state: Oregon.

Patient Financial Counselors are part of a team who has direct interaction with patients and their families either on the phone or in person. They are responsible for easing the way in resolution of patient accounts through financial clearance, payment collection, obtaining sponsorship, and financial assistance. The Patient Financial Counselor identifies eligibility, provides education, and completes and submits applications for various State and Federal sponsorship programs. They assist patients and make eligibility determinations for Providence St. Joseph Health Financial Assistance. Duties and behaviors are performed in a manner that reflects Providence's mission, philosophy, and core values.

Shift: Mon-Fri 8 am - 4:30 pm

Responsibilities:

  • Interviews patient/guarantor either face to face or via phone to capture and understand key financial data to determine the patient’s general financial situation and ability to pay for balances due or qualify for financial assistance.

  • Provides enrollment assistance when it is determined during the interview screening that a patient meets Medicaid/MediCal/Qualified Health Plan eligibility.

  • Process financial assistance applications by verifying that all information is complete and determining eligibility through established guidelines.

  • Ensure all avenues of reimbursement or third party assistance are pursued to guarantee payment for uninsured or underinsured patients.

  • Ensure charity determinations are within approval limits. Seeks leadership approval when necessary based on balance.

  • Notify patient/guarantor of approval or denial determinations within established time frames.

  • Update systems accurately and timely for FPL approvals and coverage time periods.

  • Maintain accurate, clear, concise, and complete account notes and other relevant information.

  • Provides extensive knowledge of eligibility, benefit, and payment information of various community resources to offer customer/patient in resolving account balances. (i.e. federal programs, pharmacy program, etc.)

  • Takes ownership of accounts and prioritizes incoming cases and work-in-process caseload, using principles of stratification.

  • Maintains training, certification and knowledge of state and federal Medicaid/Medicare assistance programs/requirements.

  • Maintain high level of industry knowledge of insurance benefits and provides education to customers and peers regarding insurance benefits, managed care contract discounts and payment systems (DRG, Flat Fee, Per Diem, Charge Based).

  • Completes, or facilitates completion of Medicaid applications and receipt by the state within designated timelines.

  • Assist customers in contacting third party providers or insurance companies to resolve issues as appropriate.

  • Work proactively and regularly with providers, Case Management, Transition Planners, Social Workers, about patient care plans including medication assistance programs, clinic treatment plans and/or discharge to ensure charity approvals are appropriate based on clinical as well as financial need.

  • Negotiates payment arrangements, creates payment plans, and auto payment plans.

  • Creates or assists with obtaining price estimate and performs point of service collections

  • Assist with Financial Clearance for scheduled services through education, estimates, point of service collections, sponsorship enrollment, or Financial Assistance

  • Resolves patient issues and concerns that present at the on-site office or on the phone and communicates with Revenue Cycle leadership in order to help resolve issues, as appropriate. Notifies Revenue Cycle personnel of any re-billing, charge adjustments, refunding or collection intervention that needs to occur.

  • Responsible for account follow up and resolution in assigned Financial Assistance or Financial Counseling WQ's

  • Assist with enrollment and/or education into Qualified Health Plans through the Health Benefit Exchange.

  • Completes, or facilitates completion of Medicaid applications and receipt by the state within designated timelines.

  • Educate patients and families on Social Security Disability eligibility and application process.

  • Utilizes solid judgment and adhere to all policies ensuring the protection of confidential information related to patient demographics, medical information, diagnosis codes, etc. according to both internal and Federal HIPAA regulations and guidelines.

  • Acts as resource to clinical departments, and or leadership concerning the resolution of patient concerns in financial matters.

  • Completes reconciliation of patient and/or GL payments.

  • Escalates problematic or high-risk accounts to leadership for assistance.

  • Comply with all applicable Federal, State, and local laws, regulations, and requirements as well as PH&S policies and procedures in all aspects of job performance.

  • Promote enterprise as a premier service organization by treating customers with compassion and respect by maintaining accurate, clear, concise, and complete account notes and other relevant information and closely adhering to set schedules and handle time standards.

Required qualifications:

  • High School diploma or GED equivalent(Required); college coursework preferred

  • Two or more years experience in a hospital, clinic, or healthcare business office

  • Minimum of three years experience required, or proven success as a Patient Financial Counselor Associate, preferably with Providence St. Joseph Health or it's Affiliates.

  • Experience in automated, computerized account follow-up system required, preferably in Epic.

  • Previous experience with medical and health plan terminology

Preferred Skills:

  • Knowledge in reimbursement of health care accounts from insurance companies is preferred.

  • Demonstrated outstanding public relations and interpersonal skills, by maintaining supportive interpersonal relationships with caregivers, patients, families, sponsors and team members

  • Ability to problem solve complex issues.

  • Excellent critical thinking, negotiation and organizational skills.

  • Ability to quickly extract, review and interpret information from multiple computer systems while resolving account balances.

  • Ability to maintain in depth knowledge of Federal, State, Local and contract specific requirements necessary to accurately function in a multi-payor environment.

  • Able to determine the patient’s general financial situation and ability to pay for balances due.

  • Demonstrates sound decision-making regarding payment arrangements with patients. Extensive knowledge in payment systems such as Managed Care Contracts, DRG based systems, Per Diem rates, multiple insurance benefits with deductibles and co-payments.

  • Ability to multi-task, remain calm in stressful situations and to make quick and appropriate judgments to address various situations.

  • Demonstrates knowledge of various community and PHS resources to offer a customer/patient in resolving an account balance (i.e.: federal programs, pharmacy program, etc.)

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 136477
Company: Providence Jobs
Job Category: Patient Financial Services
Job Function: Revenue Cycle
Job Schedule: Full time
Job Shift: Day
Career Track: Admin Support
Department: 4001 SS RC FIN COUNS
Address: OR Medford 1111 Crater Lake Ave

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.