PFS Financial Counselor - 40 hrs/wk, 1st shift
Blanchard Valley Regional Health Center

PURPOSE OF THIS POSITION

The PFS Financial Counselor is responsible for resolving self-pay accounts at Blanchard Valley Health System while maintaining strong relations with patients, guarantors, and revenue cycle departments. Under the direct supervision of the Patient Financial Services Department, this individual utilizes medical billing knowledge, financial assistance knowledge, and excellent customer service skills to effectively collect from and provide financial resources to patients, thereby promoting patient satisfaction and Blanchard Valley Health System's financial solvency. This individual will provide financial counseling for the patients, including but not limited to-verifying insurance eligibility and benefits, pre-screening and enrolling self-pay (uninsured and underinsured) patients for external and internal assistance programs, including Medicaid, assisting patients in the process of completing financial assistance applications, educating them about their financial responsibilities, and helping them identify a path toward resolving their balances.

JOB DUTIES/RESPONSIBILITIES

• Duty 1. Handles communication (telephone, email, interpersonal) with patients and other departments within the business office. Returns communication in a prompt and courteous manner when necessary.
• Duty 2. Follows scripts as provided by the Patient Financial Services/Revenue Cycle Leadership to facilitate consistent and expedient account resolution.
• Duty 3. Clearly explains service charges to customers, understands different payer regulations and can communicate effectively with patients regarding their Explanation of Benefits (EOB)
• Duty 4. Maintains all self-pay accounts; updates patient demographics when necessary; negotiates full payment from patients and helps them set up an agreeable payment plan and/or external payment program. Screens for financial assistance programs and directs patient to the correct resources should they be eligible.
• Duty 5. Collects patient payments made over the counter, over the phone, and by mail daily; properly records all payment types (e.g., cash, check, debit, credit) and transactions into the computer system.
• Duty 6. Daily generation of self-pay statement approval and validation of accuracy.
• Duty 7. Monitors, completes, and maintains appropriate productivity levels of assigned tasks in accordance with team standards.
• Duty 8. Prescreens uninsured and underinsured patients to identify potential financial assistance, government programs, or marketplace insurance program qualifications. If patient potentially qualifies, assists in the enrollment of these programs. Follows up with all self-pay patients admitted as inpatient or observation who have not been financially cleared.
• Duty 9. Responsible for having knowledge of all Business office functions including, but not limited to estates, bankruptcy, adjustments, cash posting, credit balances, and transmitting of bad debt.
• Duty 10. The above duties reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.
• Duty 11. Maintains a thorough understanding and education of federal and state regulations and payer specific policies and requirements to promote compliant credit and collection practices. Adheres to HIPAA related privacy, security and transaction & code set regulations in compliance with the federal guidelines. Accurately documents all account activity. Regularly attends and actively participates in staff meetings, in-service, and continuing education programs as offered. This provides needed educational updates for compliancy and organizational changes in the healthcare industry.
• Duty 12. Regularly attends and actively participates in staff meetings, training and continuing education that aligns with recognized improvement opportunities, payer policies and procedures and ensures to maintain up to date certifications. This could be remote and/or onsite as requested. Assists in other duties and projects as needed assigned by the supervisor and/or manager.

REQUIRED QUALIFICATIONS

• High school graduate or GED equivalent
• Certified Patient Financial Services Specialist certification within 12 months of hire date.
• Certified Marketplace Counselor completed within 6 months of hire date.
• 3-5 Customer service, insurance/patient billing, or related fields experience
• Positive service-oriented interpersonal and communication skills required.
• Individual must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patient served on his/her assigned unit/department. The individual must demonstrate the knowledge of the principles of growth and development over the life span. Possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to their age-specific needs and to provide the care needed as describe in the area's policies and procedures.

PREFERRED QUALIFICATIONS

• Degree in healthcare administration or related field and/or relevant work experience.
• Prior experience performing community outreach with a broad knowledge of government assistance programs, guidelines, and application procedures.
• Medical terminology
• ICD 10 and/or CPT coding knowledge

PHYSICAL DEMANDS

This position requires a full range of body motion with intermittent bending, squatting, kneeling, and twisting. The associate must be able to sit for three hours, walk for one hour and stand for two hours per day. The associate must be able to lift 20 pounds. The individual must have excellent eye/hand coordination to operate the machines. This position requires corrected vision and hearing in the normal range.

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