Patient Financial Counselor - REI/Fertility - Bozeman

The Patient Financial Counselor is the main financial contact for patients with self pay balances and/or without adequate financial resources. Looks after the financial interests of the organization by securing sponsorship for patients unable to pay and collecting from patients able to pay. Interacts with patients prior to service through financial counseling at the time of pre-registration and pre- certification, at the time of service through bedside financial counseling, point of service collections, and after service collections through tracking of Medicaid, SSI, SSDI, MCP, VA, Crime Victims, CHIP, liens, estates, financial assistance applications, bank loan program, and telephone collections.

Essential Job Functions

• Review the Physicians' schedules daily to confirm all new patients, as well as all return-to-center patients are, or will be, scheduled for a financial consult either in person, virtually, or via the telephone.
• Check all the patient’s participating insurance benefits have been confirmed. Assist in the benefit verification process as needed.
• Evaluates self-pay account balances for transfer to bad debt and assignment to outside collection agencies. Handles all functions required under bankruptcy discharges and requirements.
• Interviews patient and family members, identification of potential eligibility for SSI, SSDI, Medicaid, MCP, VA, Crime Victims, CHIP, liens, estates, financial assistance program and promotion of bank loan program. Assesses the situation and initiates the appropriate method to recommend/resolve the patient’s concern/dispute/issue.
• Negotiates within established guidelines discounts with customers, including patients, attorneys and collection agencies.
• Obtain any necessary precertification’s or preauthorization’s for all services as far in advance as possible.
• Notify patient in advance of forthcoming financial obligation and secure payment. Self Pay patients and insured patients for non covered services.
• Coordinates financial counseling efforts with entities of Billings Clinic, other physician’s offices, other community health care providers and patients regarding insurance related information, procedures cost and charge estimates, coverage issues, and options for patients without insurance.
• Keep records and maintain deficiency report of instances when unable to clear patient prior to start date.
• Work closely with the clinical team to determine if changes in treatment plan impact patient financial responsibilities.
• Work cooperatively with Patient Financial Services to support their efforts to collect patient balances.
• Follow-up with patients as necessary during the treatment plan process to ensure patients pay outstanding co-payments, balances, and coinsurance.
• Answer patient calls and/or correspondence as it pertains to procedure pricing, financial policies, billing questions, claims submission, authorizations, and any other finance related issue
• Accepts over the counter cash, check, credit /debit card payments, check by phone and finalizes bank loan paperwork with patients. Monitors, posts and adjusts on all collection agency payments. 
• Performs customer service as the primary point of contact by providing assistance to REI patient inquiries including account information, insurance billing issues (including pre-authorization or pre-certification), and quality of care issues as appropriate. Coordinates with other departments as appropriate and advises patients about the outcome. Participates as needed, and within established guidelines, in negotiation of discounts with customers, including patients, attorney and collection agencies.
• Performs financial counseling for self pay, MVA, and commercial insurance patients with deductibles greater than established guidelines, resolves any issue that the patient presents from areas in the hospital, clinics, nursing home, and other areas of Billings Clinic.
• Coordinates financial counseling efforts with entities of Billings Clinic, other physician’s offices, other community health care providers and patients regarding insurance related information, procedures cost and charge estimates, insurance coverage issues, and options for patients without insurance.
• Coordinates with social workers, care navigators and case managers on an as needed basis regarding pre-certifications/authorizations and other financial aspects on the front end of the revenue cycle in order to impact discharge planning, Medicare denial and non-covered services letters, Medicare lifetime reserve election letters.
• Establishes and monitors payments plans per policy and procedures and renegotiates payment plan arrangements when new accounts are combined into the payment plan or patient’s circumstances change.
• Works with patient financial services department to manage self-pay account balances for transfer to bad debt and assignment to outside collection agencies.