Financial Counselor

POSITION OVERVIEW:

The Financial Counselor at RCA is part of the multidisciplinary team focusing on insurance coverage, benefit eligibility, and financial responsibility for treatment. The Financial Counselor educates and assists patients with making informed decisions about payment options and financial arrangements regarding their healthcare services. Determines and verifies patient insurance coverage and eligibility for financial assistance programs. It is also the role of the Financial Counselor to help patients improve their financial health and stability which ultimately impacts the social determinants of health. The Financial Counselor is responsible for patients in RCA's inpatient and outpatient programs.

SKILLS AND EDUCATION:

• High school diploma or GED required
• Six months previous hospital registration, billing and collections, financial counseling, and/or customer service experience required.
• Understanding health insurance and benefit details required.
• Medical terminology knowledge required.

KEY RESPONSIBILITIES:

• Support enterprise revenue and EBITDA targets through managing collection of patient financial responsibility (PFR) and enrollment of patients onto payment plans.
• Meet with all new patients within 72 hours of admission to review benefit details including estimated financial responsibility.
• Attend daily flash meeting to notify the multidisciplinary team about any financial issues, concerns, and/or outcomes related to all patient cases.
• Works closely with the multidisciplinary team daily regarding patient status changes in coverage for treatment services.
• Ensure all relevant financial forms are completed, signed, and documented according to all RCA policies and procedures.
• Provide education to patients and families about payment options and financial assistance to cover treatment.
• Determine and collect payments for financial responsibility including setting up a payment plan when necessary.
• Accurately document how financial responsibility will be collected.
• Support and assist in collection of co-pay for outpatient treatment services.
• Ensure all relevant patient financial information is entered into the electronic system.
• Ensure financial registration is accurately set up and documented in the electronic health record for patients who are Private Pay.
• Secure payment for all Private Pay patients including but not limited to treatment services, private room, and Recovery Housing.
• Secure self-pay for those patients/families who wish to continue treatment but are denied additional time due to not meeting the insurance company's medical necessity criteria.
• Consistently works to develop new and innovative systems to help maximize patient days.
• Manage all eligibility processes and patient follow up related to policy changes and policy terminations.
• Assist patients to reinstate health care benefits when insurance policy has terminated. Coordinate with employers, human resource departments, and insurance companies who provide benefits to determine steps to reinstate health insurance coverage.
• Identify eligibility for medical and financial assistance programs and assist in completion of the application process when warranted.
• Stay informed with changes in State and Federal laws and regulations regarding insurance/third party administrators.
• Manage RCA's Daily Collection Reconciliation processes including accurate reporting of collections and depositing payments according to protocols.
• Maintains complete documentation of activities performed on account while in-house. Appropriately report and document all interactions with patients, families, employers, etc.
• Collect fees for professional services provided. Collaborate closely facility leadership and various departments at the Enterprise Support Center (ESC) including the Mission Center, Patient Financial Engagement Specialists (PFES), and the Finance and Operations teams.
• Participates in data gathering for financial reporting. Conduct face to face discharge meetings with patients, including any account reconciliation and payment arrangement to bring account to a zero balance.
• Participate in the discharge planning process, including keeping relevant management and treatment staff up to date on progress.
• Assist with the resolution of authorized days and outcomes related to uncovered days requiring payment and financing.
• Assist with pharmacy related workflows to ensure pharmacy has banking information for co-pays for all patients.