Financial Counselor Case Worker

Description

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities.

Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.

Financial Counselor is responsible for assisting primarily uninsured and under-insured patients as they move through the financial continuum from scheduling through claim adjudication. Financial Counselors work directly with patients to maximize reimbursement through governmental programs and alleviate patient obligations through the Organization’s Financial Assistance Program. The position requires a high degree of intellect and critical thinking skills to make appropriate decisions of a complex nature which can have a significant financial impact on the Organization.

Staying abreast of ever-changing laws and regulations mandating Medicaid eligibility and adherence to the Organization’s Financial Assistance Policy are essential components of the job. The Financial Counselor works both independently and as a productive member of a highly collaborative team, to secure reimbursement whenever possible, and assist our patients with qualifying for charitable assistance from the Organization when reimbursement is not feasible.

• Identify the best source of financial assistance available based on screening and evaluating a patient’s unique financial circumstances and future medical needs, performing a complex analysis of the patient’s income, assets, and financial liabilities.
• Assist uninsured and underinsured patients with applying for State and Federal governmental assistance programs, as well as charitable assistance from the Organization. Help patients gather all appropriate documentation and complete all necessary applications.
• Identify the need to schedule appointments and travel to meet patients in the community for any necessary components of outstanding documentation on applications.
• Conduct interviews at bedside to ensure optimal customer service and personal attention.
• Collaborate with Clinical Resource Management, providers, clinical departments, revenue cycle departments, and the Insurance Verification Team to address patients’ financial needs and secure potential sources of funding, expediting timely advancement through the continuum of care.
• Perform insurance eligibility verification and execute payer requirements as needed, including initiating eligibility transactions via the internet, contacting the payer to obtain eligibility, benefits and billing information, and updating information to ensure correct financial classification on patient accounts.
• Collect payments from patients, including prompt pay discounts and discussing payment arrangements.
• Participate in the continuum of the life of a claim by working collaboratively with the collection departments to identify patients that may need assistance, including review and recommendation for bad debt based on historical patient information.
• Stay abreast of ever-changing laws and regulations mandating Medicaid eligibility.
• Fulfill all compliance responsibilities related to the position, maintaining ethical integrity while processing applications for government funding and other assistance programs.
• Maintain and model Nuvance Health values.
• Demonstrate regular, reliable, and predictable…