Financial Counselor

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• Interview patients to obtain legal relevant medical information and all required documentation for eligibility determination and accurate application completion to avoid rejections/delays in payment and increase to AR.
• Screen and evaluate patients for existing insurance coverage, federal and state assistance programs or hospital charity application.
• Screen uninsured patients for state and federal insurance programs;
  Medicaid, All Kids Marketplace, Medicare or VA Programs.
• Counsel patients on insurance benefits, copayments, and coinsurance amounts. Assist patients with payments, payment plans, or applicable options to ensure DCH is reimbursed for services rendered.
• Operate as collector to accept patient payments via cash, credit or checks, document applicable systems and provide patient receipts.
• Ensure all insurance, demographic, and eligibility information is entered into the EMR accurately and appropriate signatures are obtained on all required forms for clean claim processing.
• Serve as liaison between the patient, hospital and governmental agencies; actively involved in financial areas of case management for supportive patient advocacy for best patient experience.
• Initiate and complete charity application on at‑risk accounts or items not obtained at registration to avoid financial loss or payment denial for DCH.
• Maintain proper follow‑up with the patient and governmental agency caseworkers to ensure timely processing, including requests for additional information.
• Work report each week and document account notes of application status for all pending applications.
• Escalate at‑risk accounts to leadership.
• Review financial data and multiple program requirements to determine possible Marketplace eligibility or other government insurance.
• Determine estimates for patients to secure adequate payment arrangement with patient for scheduled services in compliance with the No‑Surprise Act.
• Provide reports and analysis to Assistant Director on insurance discoveries or secured Medicaid, Marketplace or charity applications.
• Participate in process improvement activities and efficient workflow between Patient Access and Billing for clean claim processing.
• Exercise problem‑solving skills independently or within a group setting for best financial outcomes.
• Verify or re‑verify benefits or initiate or obtain authorization and/or referrals, including validation of traditional or HMO plans, commercial coverages within payer timelines to ensure reimbursement to DCH.
• Work collaboratively with Case Management and Discharge Planning to raise awareness of community resources and engage patients and family members as needed.
• Maintain understanding of all regulatory, HIPAA and payer guidelines.

• Maintain performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation.
• Perform compliance requirements as outlined in the Employee Handbook.
• Adhere to the DCH Behavioral Standards, including creating positive relationships with patients/families, coworkers, colleagues and oneself.
• Perform essential job functions in a manner that ensures the safety of patients, visitors and employees.
• Identify and reduce unsafe practices that may result in harm to patients, visitors and employees.
• Recognize and take appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees.
• Require use of electronic mail, time and attendance software, learning management software and intranet.
• Adhere to all DCH Health System policies and procedures.
• All other duties as assigned.
• Associate Degree or High School diploma/GED with prior advocacy/Revenue Cycle experience of at least two years in a healthcare setting.
• Must be able to use computer efficiently to register patients in a timely manner.
• Good communication skills: pleasant voice and speak with clarity.
• Must be able to interact well with the public and staff.
• Must be able to read, write and speak English.

Carry up to 30 pounds, occasionally required to push, pull, bend and lift. Ability to push a wheelchair, assisting with entry or exit. Able to stand, walk, kneel, sit or stoop with good balance for extended periods of time or when visiting patient rooms or clinical units to interview patients and obtain information. Vision and hearing normal or corrected to normal.

Can write legibly. Must have ability to communicate with others. Mental capability to maintain patient confidentiality 100% of the time. Subject to stress and fatigue.