Financial Resolution Advocate

The Financial Counselor-Cashier interprets and applies financial policies to make appropriate financial decisions and payment arrangements to ensure financial viability. Prepares and presents fee estimates to current and potential patients. Provides financial education regarding benefits to patient to assist in understanding their personal financial liability. Demonstrates the ability to assertively pursue necessary information and to function independently to secure financial resolution on accounts.

This role is also responsible for the timely and accurate posting of patient payments and adjustments to the patient accounts. Also responsible for daily cash and adjustment reconciliation with the patient account system and the accounting department for payments made at the hospital.

• High school graduate or equivalent.

• Two (2) years’ experience in a healthcare setting.

The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

• Interviews patients who are referred for financial counseling in person or via the telephone to determine financial counseling needs and to help formulate a plan for financial resolution.
• Uses CPT codes to calculate the estimated procedure cost.
• Based on information provided by the patient, an initial determination will be made if the patient has adequate benefits or qualifies for Medicaid, special programs or payment arrangements based on federal, state and hospital policy.
• Educates patient on their benefits, patient liability and/or the process for applying for Medicaid, completion of the financial statement and payment alternatives.
• Informs patients of hospital and clinic billing practices/policies and their rights and responsibilities regarding payments.
• Insured patients who are responsible for a balance after insurance will receive a preliminary financial overview and will be assisted in completion of the financial statement if necessary for financial resolution.
• Reviews completed financial statements and makes a determination based on hospital policy if the patient qualifies for a payment arrangement and documents in the registration/billing systems.
• Works with specialty departments to establish appropriate financial arrangements for elective services.
• Identifies and accurately resolves potential patient account issues for WVUH and UHA billing departments.
• Resolves billing questions for patients who present to the Inpatient, Chestnut Ridge or Physician Office Center patient services area.
• Monitors daily reports to identify large dollar account balances and private pay patients that need resolution.
• Refers patients to local, state and/or federal agencies for assistance.
• Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing. Obtains and scan patient’s insurance/medical cards and driver’s license into the registration system.
• Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems.
• Balances daily receipts and cash drawer for patient payments, prepares and delivers deposit bag to cashier’s office.
• Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers).
• Maintains registration accuracy threshold of 98% as identified in audit processing.
• Initiates auto accident liability coverage. Identifies all patients involved in an…