Department/Position Details/Duties:

• The Financial Counselor serves as a patient advocate.
• Reviews and inputs all surgery cases into the spreadsheet from the previous day, including add-ons.
• Collaborates with external parties to verify the patient's insurance coverage prior to services being rendered which includes calling or using a portal.
• If insurance coverage is found to be termed or unable to be verified the financial counselor is responsible for reaching out to the patient prior to services being rendered to obtain and update their insurance information.
• The Financial Counselor calculates the upfront surgical payments, develops the upfront letter, scans the upfront letter into the patient's chart, documents the account of the amount due upfront from the patient/guarantor prior to the services being rendered.
• Contacts the patient/guarantor to discuss the pre-payment process advising patients over the phone, via email, and/or via text message of their insurance coverage and benefits along with their financial responsibility.
• Collects payments for both clinic and hospital if required utilizing online payment applications.
• Assists with payment arrangements as per our policy and if appropriate offers financial assistance sending out the financial assistance application based on the current poverty guidelines.
• Reviews financial applications returned by the patient/guarantor using the financial assistance worksheet. Reviews the application, verifies account details, and all necessary documents and uses poverty guidelines based on household income for verification.
• Notates account regarding the approval or denial of the financial assistance application. Sends letter to the patient/guarantor regarding the outcome of the application.
• Enter appropriate adjustments to the account dependent on the outcome of their financial assistance application.
• Responds to "bad debt" emails to inform staff of the patient's current status with our outside collection agency by contacting collection agency to verify payment arrangements and the notate account.
• Prepares ABN/Waivers for patients who are requesting services that are non-covered or deemed not medically necessary per their insurance company and informs Patient Access if a ABN/Waiver is needed to be signed at check-in.
• Prepares GFE (Good Faith Estimate) for self-pay patients with scheduled services at any location at OrthoNebraska and informs patient via phone, email and/or text message of the estimated costs prior to services being rendered.
• Takes both inbound/outbound calls regarding payment plans, financial assistance and or other questions pertaining to their financial situation.
• Maintains patient confidentiality by understanding HIPAA regulations.
• Participate in performance improvement activities.
• Attend and participate in department meetings.
• Follow established guidelines as stated in the policies and procedures of Patient Financial Services at OrthoNebraska.
• Informs Assistant Manager/Manager of patient complaints and/or issues in a timely manner.

Skills Needed:

• This position requires a great deal of time management.
• Must be able to demonstrate calm and rational thinking and be able to communicate and provide detailed explanations in a clear and concise manner.
• Must be able to multi-task with multiple interruptions in a fast-paced environment.

Position Requirements:

Education:

• Associate degree preferred. Equivalent experience and credentials may substitute for education.

Experience:

• 3 years' experience in a Health Care setting with emphasis on patient accounting principles and customer service.
• Experience with Cerner application preferred but not required.

Physical:

• This position is classified as Sedentary Work in the Dictionary of Occupational Titles, requiring the exertion of 10 pounds of force occasionally (up to 33% of the time) and/or a negligible amount of force frequently (33%-66% of the time) to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary Work involves sitting most of the time but may involve walking or standing for brief periods of time.

Must be able to pass background check. We also conduct pre-employment physical and drug testing. Any job offer will be contingent upon successful completion of a pre-employment physical with a drug screen, background check and obtaining active licensures per job requirements.