Overview

At Legacy, we understand that making life better for others involves compassion in all of our interactions. Guiding patients toward important financial decisions while being sensitive to difficult or stressful circumstances is an important aspect of the care we provide. If you share this commitment and you’d like to grow with our patient-focused healthcare system, we’d like to talk to you.

The financial counselor assists patients and their families often in difficult times, providing financial, insurance and payment options to resolve patient balances. In addition, the financial counselor helps patients applying for various financial programs such as Oregon Health Plan, Medicaid, Crime Victims and Charity Care, and provides cost estimates upon request.

Legacy Emanuel Medical Center in North Portland plays a vital role as a local and regional leader in serious clinical illness or injury. With around-the-clock expertise for critical health issues, including experts in trauma, heart care, burns, significant wounds, stroke, brain surgery and more, Legacy Emanuel is central to the health of our community and critical to the care of the Northwest.

Responsibilities

Provides Customer Service

Effectively communicates directly with patients, families, physicians, payors, attorneys, Clinical Resource Coordinators, Utilization Review Coordinators, and toerh providers while inhouse (patient), in person, by phone, or written correspondence. Maintains positive communication and presentation skills with patients/customers of diverse ethnic cultural backgrounds and sensitive financial situations. If unable to contact patient while inhouse, contacts patient after discharge to discuss financial arrangements.

Ensures all accounts for patient are discussed with patient at time of contact.

Reviews patient account to determine if balance billed for is correct.

Accurately communicates account status and pending action to customers.

Coordinates patient account affects of pre-authorizations, second opinions, insurance benefit limitations, high dollar deductibles/copays with patients and families while maintaining positive personal relations. Assists patients in determining eligibility for Cobra assistance.

Determines if patient meets OHP eligibility criteria; may meet directly with patient or family member to complete OHP form and enroll patient in OHP. Also assists patients with other available financial resources such as Crime Victims, Medicaid in other states, Family Health Insurance Assistance Program (FHIAP) and Charity Care.

Sets Payment Arrangements

Understands and communicates Legacy payment policy to patients, guarantors and other appropriate individuals.

Calculates payment options per Legacy policy, abiding by laws governing payment plans and payment contracts.

Documents all options discussed and payment plan established.

Monitors payment plans after they have been established.

Rebills, transfers payments, requests refunds or adjusts misapplied payments as necessary.

Reviews pre-admit accounts to determine if an account is truly self-pay, determines medical necessity, then contacts patient/guarantor regarding, deposits, payment arrangements or OHP.

Performs Account Service

Sets deadlines for future action on accounts; action taken includes but is not limited to scheduling follow-up, making adjustments, placing phone calls, turning accounts collections, checking for insurance coverage as necessary, and making payment arrangements.

Understands and follows Legacy procedures for writing off small balance accounts.

Request refunds when appropriate

Determines when an audit is necessary.

Understands and abides by laws governing customer Bankruptcy filings.

Understands and abides by Legacy policy relating to accounts of deceased patients and laws governing account responsibility.

May interview customers and assist as appropriate in obtaining needed demographic, insurance, health and financial information and completed/signed forms required for services and confirmation of payment source.

Obtains pre-admission deposits.

May verify insurance coverage, reviewing and validating registration, additional insurance, and provider information.

Transfers appropriate accounts to hospital attorney

Follows up on requests from attorney for billings, obtaining lien satisfactions, medical records or itemized statements.

Provides advice to attorney on settlement questions.

Maintains a working knowledge pertaining to Insurance Issues, which includes but is not limited to Motor Vehicles, Workman’s Comp, Medicare, OHP/Washington Welfare/Medicaid Blue Cross and Commercial payors.

Participates in Oregon Health Plan (OHP) training classes.

Qualifications

Education:

High school graduate or equivalent

Experience:

Two years of directly applicable healthcare business office experience and/or applicable self pay collection experience

Skills:

Demonstrated negotiating, problem-solving and decision-making skills.

Demonstrated understanding of complex collection issues inherent in high dollar/specialty accounts.

Demonstrated knowledge of multi-payor systems.

Demonstrated knowledge of billing/collection rules and regulations.

Knowledge of online eligibility systems and status review of claims.

Net Typing of 40 wpm and PC based computer skills.

10 key proficiency.

Knowledge of medical terminology.

Ability to work efficiently with minimal supervision, exercising independent judgment within stated guidelines.

Demonstrated effective interpersonal skills that promote teamwork and cooperation.

Ability to withstand varying job pressures, organize/prioritize related job tasks and demonstrate excellent attention to detail.

Excellent public relations skills and demonstrated ability to communicate in calm, businesslike manner.

Ability to multitask, learn new skills, and adapt to change.

Ability to work in a fast-paced environment independently or as part of a team

Legacy's Values in Action:

Follows guidelines set forth in Legacy's Values in Action

Equal Opportunity Employer/Vet/Disabled