Financial Counselor

Overview

Provides financial counseling to patients by interviewing patients, verifying insurance coverage, establishing payment arrangements, determining eligibility for financial assistance, and other related activities to maximize reimbursement to the Hospital for services rendered. Brown University Health employees are expected to role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide everyday actions with patients, customers and one another.

All employees are expected to demonstrate the core Success Factors:
Instill Trust and Value Differences;
Patient and Community Focus and Collaborate; and other success factors that guide work together and how we get things done.

• Demonstrates understanding of Hospital's Mission, Vision and Values.
• Demonstrates understanding of job description, performance expectations, and competency assessment plan.
• Demonstrates a commitment toward meeting and exceeding the needs of our customers and consistently adheres to our Customer Service Standards.
• Complies with department and hospital policies and procedures.
• Reviews policies and procedures and Employee Handbook.
• Completes mandatory safety management education (hospital-wide, department-specific, job-specific).
• Participates in departmental and/or interdepartmental quality improvement activities.
• Reviews and analyzes all pre-admission, admission and outpatient account data daily to determine each patient's financial status.
• Contacts patients, employers and insurance companies to verify coverage, patient balance responsibilities and determines eligibility for assistance.
• Meets with patients and/or their families to obtain needed third party billing forms, signatures of financial responsibility, collects private room balances, insurance co-payments and deductibles due.
• Reviews the scope, type and terms of health insurance contracts with patients and their families, utilizing the Hospital's financial policy to determine adequacy of coverage.
• Determines selected patients' eligibility for the Uncompensated Care and Bed Fund Programs by gathering the appropriate eligibility information to expedite approval or denial within specified time frames.
• Processes applications for Uncompensated Care according to Federal Register regulations.
• Refers patients in need of financial assistance to state, federal and other agencies and completes applications, obtains required documents and files with appropriate agency.
• Provides information to agencies relative to the financial obligation of the patient as requested.
• Initiates applications for catastrophic health insurance programs as appropriate.
• Follows up with patients who are rejected for assistance to discuss and arrange alternative reimbursement options before discharge from the Hospital.
• Negotiates payment schedules with patient and re-negotiates schedules to accommodate changes in patient financial condition.
• Initiates promissory notes and payment arrangements and obtains proper signatures on the notes.
• Refers appropriate patients to selected banks for loans to pay Hospital services.
• Utilizes a current and comprehensive knowledge of the Newport Hospital charge and rate schedule to establish adequate payment arrangements.
• Implements Newport Hospital's financial policies to maximize collections and decrease bad debts.
• Develops and maintains effective working relationships with local physicians, their office staffs, and other Hospital departments to ensure mutual understanding and acceptance of the Hospital's financial policies and correct errors and clarify misunderstandings.
• Notifies other Hospital departments of reimbursement requirements relative to each individual patient account, as appropriate.
• Coordinates reporting of such information to the insurance carrier, mindful of patients' rights while ensuring maximum reimbursement from third party payers.
• Documents all pertinent patient account information in the patient account notes regarding the scope of insurance coverage, billing instructions, prior payment listing, and patients' plans for payment of balances due.
• Revises and updates all patient demographic and/or insurance information in both Registration and Financial computer systems to ensure accurate patient account data.
• Arranges inter-bank transfers of funds for patient payments including wiring of monies from banks outside the United States.
• Schedules patient's family interviews for discussion of limitations of coverage or payment denial issues at the convenience of the family, including hours beyond the regular scheduled business day.
• Obtains additional information as needed from the patient and/or representative to ensure timely filing of a Hospital lien, where a third party may be held liable for a patient's injury.
• Prepares a status report monthly for inpatients hospitalized over 30 days or whose balances exceed $15,000.
• Researches and resolves billing questions from walk-in patients with assistance of corporate customer service…