Financial Counselor

SUMMARY:nnUnder the general supervision of the Manager Patient Registration, the Financial Counselor functions as a liaison between the hospital and patients to facilitate the solution of patient financial issues concerning outpatient and inpatient pre-admission, pre-registration, pre-scheduled, scheduled, inpatient/observation, direct and emergent admissions.nBrown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.nnIn addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:nnInstill Trust and Value DifferencesnPatient and Community Focus and CollaboratennRESPONSIBILITIES:nnPre-admits/registers scheduled outpatients and inpatients in hospital system.nContacts insured patients to verify demographics obtained at the time of scheduling to complete any missing information.nVerifies patient insurance coverage (both primary and secondary) online or by telephone.nObtains and verifies coverage authorizations for scheduled and unscheduled patients, to include all sources such as Worker 's Compensation, Medicare Secondary Payer (MSP), Medicare liability, liens, etc.nEnsures referrals are obtained and confirms accuracy of the Primary Care Physician (PCP).nEstablishes level of insurance benefits and expected payment for selected services. Determines the patient 's portion of payment, when applicable, and arranges for payment prior to the provision of services.nUpon arrival or admission, or in the patient 's room, completes any missing documentation required from patients and/or family members.nChecks outstanding balances incurred for previous services prior to contacting patient and follows collection policy concerning prepayment prior to the provision of additional services.nMonitors in-house accounts for open patient balances resulting from co-payments and deductibles. Tracks Medicare Days and Lifetime Reserve Days, when applicable.nAuthorizes occupancy and collects payments for Private Room Differentials. Reviews bed transfer list daily to ensure the authorization and collection of all appropriate private room transfers.nWhen appropriate, medical necessity verifications for services to be provided will be performed by the servicing department and will also require that Advance Beneficiary Notices (ABNs) be addressed for payment at the time of admissionrrival.nRefers insured patients who cannot meet their financial obligations, including previously incurred hospital balances, current admission/outpatient expected non-covered charges, and ABNs to Patient Advocates according to department policy.nUpdates status of financial clearance activities in hospital system.nPreparesssembles all necessary paperwork prior to the patient 's arrival.nReviews/corrects third party payer eligibility reports.nCompletes real time status transfers.nPerforms other duties as required to support the operations of the department.nMay be required as needed to provide coverage at numerous locations (hospital-based): Admitting, ED, and Outpatient areas as well as off-site registration areas and Business Office.nAttends and participates in staff meetings.nnMINIMUM QUALIFICATIONS:nnBASIC KNOWLEDGE:nA level of knowledge generally obtained through completion of High School.nKnowledge of medical terminology, third party insurance information, and standard computer applications required. Good verbal and written communication skills.nComputer skills that permit and facilitate the performance of work responsibilities.nDemonstrated knowledge and skills necessary to provide care patients with consideration of aging processes, human development stages and cultural patterns in each step of the care process.nEXPERIENCE:nTwo years in a hospital environment with previous experience in third party payer verification and authorization process requirements, and an understanding of payer contracts. Training in HIPAA rules and regulations.nWORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:nOffice environment with some exposure to the normal patient care environment as some patient interviews are conducted with patient and family members on the nursing units. Sitting for long periods of time at a workstation requiring continuous use of a computer and telephone.nINDEPENDENT ACTION:nPerforms independently within the department 's policies and practices. Refers specific complex problems to the supervisor when clarification of departmental policies and procedures are required.nSUPERVISORY RESPONSIBILITY:nNone.

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EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

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