Financial Counselor

Job Details

Job Location
:
Hillside Inc - Atlanta, GA 30306

The Financial Counselor is responsible for verifying health insurance benefit coverage for prospective and existing Hillside clients. The Financial Counselor will provide excellent customer service while collecting monies owed to Hillside through insurance out‑of‑pocket as well as self‑pay expenses. The Financial Counselor will carefully project the amounts owed by Hillside’s clients and review the breakdown of these cost estimates with the financially responsible party.

Key to the Financial Counselor role is clearly informing parents and/or guardians of the amount due prior to admission, then applying insurance company payments and actively monitoring patient accounts throughout the service delivery period. As discrepancies arise, the Financial Counselor is responsible for proactively resolving all financial issues with the designated financially responsible party, prior to and subsequent to the client’s discharge from Hillside services.

• Completes health insurance benefit verification for clients admitting to Hillside
  • Verifies the eligibility of the prospective client for the identified program track, as well as other program tracks offered by Hillside
  • Based on the benefit quote from the insurance representative and web database(s), estimates the financial responsibility for the prospective client
  • Documents the verification of benefits and the estimated financial responsibility, utilizing the designated forms and saving them in the designated locations
  • Shares pertinent information with appropriate parties internally (i.e. confirming coverage, noting non‑coverage / exceptions / exclusions, etc.)
• Reviews and collects estimated financial responsibility from prospective clients
  • Reviews the estimated financial responsibility (i.e. Out of Pocket costs) with the financially responsible party
  • Collects payment for the entire balance estimated to be owed
    • Sets up payment plans upon request, following established processes
• Creates customer statements and accounts*
  • Each day, runs admissions report from Hillside’s Electronic Health Record
  • Creates client statement in Excel and client account in accounting software for each admitted client
    • * This responsibility will remain until Hillside has completely transitioned to running all client accounts out of the Electronic Health Record
• Resolves insurance benefit issues that arise during or after services
  • When notified about a coverage or benefit issue (i.e. lapse in coverage, coordination of benefits, etc.), intervenes to resolve the identified issue with the financially responsible party
  • Shares pertinent information with appropriate parties internally
    • May include:
      Admissions, Billing, Utilization Review, Revenue Cycle Specialist, and others as needed
• Reverifies benefits and collects additional payments, as needed
  • Verifies benefits prior to a client transferring from one program to another within Hillside, ensuring that the client has the correct benefit before services begin
    • Follows up with the responsible party regarding additional payment, when relevant
    • Collects payment and answers questions, as needed
    • Communicates internally regarding any potential barriers to collecting payment
  • Verifies benefits as needed to confirm active coverage for current clients
• Collects payment from clients transitioning to self‑pay
  • Collaborates with the clinical team and follows up with clients potentially transitioning to self‑pay to accomplish the following:
    • Reviews self‑pay costs with the family, including the first day self‑pay costs apply
    • If the client is transitioning to self‑pay:
      • Obtains signed self‑pay form (and files appropriately)
      • Collects payment and manages payments until discharge
    • Keeps the clinical team informed as to the status of outreach to the family (i.e. the family has paid for x number of days of self‑pay; the family refuses to pay for self‑pay; the family has not responded to outreach attempts; etc.)
• Proactively manages client account balances
  • Reviews client accounts following admission
  • Collects payments as needed
  • Issues refund requests when appropriate
  • Communicates with families regarding account balances, following established…