ED Financial Counselor

Summary

Obtains and records patients’ personal and financial information as it is related to hospital admissions, patient scheduling or other registration functions in the Emergency Department to ensure that PAS KPI standards are met or exceeded as well as follows the Emergency Treatment and Active Labor Act (EMTALA) guidelines and MLH processes. Counsels patients and/or parties responsible for payment regarding payment responsibilities and options. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

Knowledge/Skills/Abilities

• Knowledge of and experience using medical terminology.

• Knowledge of general business operations, scheduling, insurance and coding.
• Knowledge of data entry and general office procedures.
• General computer skills necessary to work effectively in an office enivornment.
• Strong critical thinking skills.
• Strong attention to detail skills.
• Strong customer service skills in person and via telephone or e-mail.
• Excellent organizational, verbal and written communication skills, including spelling and correct grammatical structure.
• Ability to perform basic mathematics.
• Ability to follow and apply insurance guidelines/requirements regarding Third Party Payors, Coordination of Benefits, and Managed Care contractual requirements.
• Ability to handle stressful situations.
• Ability to prioritize and manage multiple task simultaneously, and to effectively anticipate and respond to issues as needed in a multi-faceted work enivornment.
• Ability to understand and interpret complex written materials such as insurance matrices, Point of Service calculations and patient records.
• Ability to develop solutions to complex problems, which require ingenuity, creativity, and innovativeness.
• Ability to exercise independent judgment in making decisions and resolving complex problems related to general and technical aspects of the position.

Key Job Responsibilities

• Obtains and verifies patients’ demographic and financial information. Ensures all information is accurate and complete.
• Performs financial counseling process on all patients prior to service, which includes patient financial obligations, billing practices and establishing payment arrangements.
• Analyzes patient insurance coverage, researches probability of coverage based on known criteria, and provides information for patients in need of financial assistance.
• Identifies problematic encounters and follows through as appropriate.
• Understands, applies, and supports departmental/hospital policies, procedures, and standards. Attends meetings, in-services and training sessions as required/requested.
• Performs other job functions as assigned or requested.

Physical Requirements

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
• The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.