The Financial Counselor, in conjunction with the supervisor, performs financial clearances for Inpatient, STP, Day Feeding and H&C admissions.
Responsibilities1. Verifies, analyzes, interprets and documents patient health insurance coverage, health plan provisions or other third-party payment plan arrangements for inpatient admissions, STP, Day Feeding and H&C admissions.
2. Conducts in-person or phone interviews with patient representatives to secure accurate information relative to financial status and cost of services.
3. Secure authorization for Inpatient and Day Programs
4. Responsible for Inpatient Medical Assistance tracking of the 3808 authorization and billing process. Coordinates the long term care application process with the DSS worker to ensure timeliness of applications; follows-up on the status of applications with the local DSS department and ensures that
authorizations are issued as quickly as possible so that billing can begin.
5. Evaluates funding sources and alternate funding sources of payment for Inpatient, STP, Day Feeding and H&C admissions; follows through until sources are exhausted or obtained. Establishes eligibility for financial assistance for healthcare services provided without charge or at a discount to qualifying patients.
6. Estimates deposit requirements, determine patient liability, establishes payment arrangements, and monitors payment agreement with Patient Accounting.
7. Verify all Medicaid inpatients on a daily basis using the State of Maryland Medicaid Eligibility Verification System.
8. Update Census Reports for rotating attending physicians.
9. Generates registrations, data cards and face sheets for Inpatient, STP, Day Feeding and H&C.
10. Obtain consent for treatment and authorization for release of medical records for inpatient.
11. Negotiate rates for Inpatient, STP, Day Feeding and H&C.
12. Enrolls Institute providers into various payor groups and maintains a Provider Billing Information database to ensure timely re-enrollment of providers.
EDUCATION:
High School Diploma or GED required.
AA degree in Business preferred.
EXPERIENCE:
One year experience in healthcare as it relates to admissions and patient accounting.
RELATED TRAINING:
Must be proficient with MS Office suite
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