Financial Counselor (Emergency Dept.)

FLSA Status

Job Role Summary

Essential Functions and Responsibilities

• Accept daily assigned customer referrals in management designated systems to determine customers to be screened/interviewed
• Assist walk-in customers as they present
• Explain available payer programs and benefits to customers, including Healthy Indiana Plan, various Medicaid or State programs and services, Health Insurance Marketplace, COBRA, or any other possible third party payer sources, or the hospital's charity program, Health Advantage
• Interview/screen customers for all potential payer programs as described in previous job function
• Assist customer with information necessary for securing verifications from various companies/agencies (Work One, banks, life insurance companies, health information, physician offices, Social Security Administration, Health Department etc.)
• Complete timely submission of documentation and application in management designated system(s), adhering to all deadlines and requesting extensions from management when necessary
• Document and update application status in management designated system(s) on a regular basis
• Maintain confidentiality of patient health information in compliance with HIPAA regulations
• Contact patients by phone, correspondence, or home visit to continue to secure necessary documentation
• Monitor progress of applications to ensure application completion and processing timelines are adhered to
• Attend interviews (phone or in-person) with State, County or other payer program representatives for those patients with signed authorization that are determined not able to participate, have requested representation, or have a history of lack of cooperation
• Update management designated system(s) with eligibility determinations and update all appropriate STAR accounts if eligibility is retroactive
• Estimates patient's financial responsibility for services currently rendered (patient's currently admitted as Inpatient or Observation) and secures payment or payment commitment as deemed appropriate by Management
• Mentor peers, including training as needed
• Ability to meet all productivity and quality requirements

Job Requirements

• High school diploma required; Associate or Bachelor's degree or equivalent work/business experience in a healthcare or public assistance setting required.
• Must have a valid Indiana driver's license that meets Eskenazi Health's driving policy requirements
• Bilingual in English and Spanish preferred

Knowledge, Skills & Abilities

• Extensive knowledge of eligibility policy rules and processing requirements for programs administered by CMS, FSSA, and other applicable State and Federal programs
• Extensive knowledge of health care related insurance rules and guidelines, coverage and benefit plans, and strong ability to calculate and demonstrate insurance and patient payment methodologies and respective amounts due
• Strong investigative, analysis and judgment skills
• Excellent spelling and grammar; good phone skills; basic math skills; organized, set priorities, meets deadlines; ability to multi-task and carefully proof own work
• Must demonstrate effective communication skills by conveying necessary information accurately, listening effectively and asking questions when clarification is needed
• Ability to work independently and as part of a team
• Professional demeanor in person, email, and over the phone
• Proficiency in Microsoft Office Tools
• Must be sensitive to the medical needs of customers and professional duties of hospital staff
• Ability to adjust to changes in policies, procedures, and systems
• Must meet all federal and state required navigator training and certification requirements