This paragraph summarizes the general nature, level and purpose of the job.
The Financial Counselor Level 1 role screens uninsured and underinsured patients at bedside and prior to or post services to identify government or charity programs to cover medical expenses. The position requires a patient financial interview which includes a review of hospital charges, the patient’s insurance status and financial resources. It may include the completion of appropriate applications and diligent follow up for approval. This individual must possess the ability to effectively communicate, both orally and written, to a variety of individuals including: patients, case workers, social workers, hospital directors and executives while maintaining utmost professionalism. Must be multi-task orientated with excellent critical thinking skills and possess the ability to appropriately handle complexity and stress within the changing needs of the patients, families and the health system. It is expected that individuals in this level will acquire the necessary job skills, knowledge, team leadership and other qualifications through on-the-job and/or formal training in order to advance to the Financial Counselor II level.
The essential functions listed are typical examples of work performed by positions in this job classification. They are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned.
Employees must abide by all Joint Commission Requirements including but not limited to sensitivity to cultural diversity, patient care, patients’ rights and ethical treatment, safety and security of physical environments, emergency management, teamwork, respect for others, participation in ongoing education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals, and licensure and health screenings. Must perform all duties and responsibilities in accordance with the Service Standards of the Hospital(s).
Provides excellent customer service to all individuals with whom the employee has contact. Employee must perform all duties and responsibilities in accordance with the C-I-CARE Standards of the Hospital. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions.
· Finds solutions to help address patient financial needs in accordance with Stanford Health Care policies and procedures.
· Determines financial clearance for a patient's visit or referral (pre-service or at time of service). Checks eligibility and benefits, determines authorization requirements have been met.
· Assesses 'risk' of cases that have not been financially cleared/secured prior to service. Clears low risk cases, escalates high-risk cases to coordinator or manager. Contacts patient regarding steps required to clear their appointment for services including collecting a deposit for the patient’s financially responsible portion.
· Quickly and accurately estimates a patient's out of pocket costs and prepares documents to present to the patient for payment. Assures secure handling and accurate recording of payments collected at the point-of-service delivery.
· Applies strong problem solving skills to help address the concerns and needs of the patients that the Financial Counselors serve
· Effectively communicates, both orally and written, to a variety of individuals including: patients, case workers, social workers, hospital directors and executives while maintaining utmost professionalism.
· Maintains professional communication with various Patient Financial Clearance and Patient Access Services staff, medical center staff, physicians, guests, and patients regarding the services rendered at Stanford Health Care. Communication may consist of telephone correspondence or in person contact.
· Must be multi-task orientated with excellent critical thinking skills and possess the ability to appropriately handle complexity and stress within the changing needs of the patients, families and the health system.
· Meets weekly individual productivity goals and standards while following planned priorities as set by the Team Manager/Coordinator(s)
· Performs other duties and responsibilities as assigned by the unit team manager or other PFC management personnel.
· Performs the complete registration and admitting process from start to finish.
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Education: High school diploma or GED equivalent
Experience: At least 1 year of progressive responsibilities in a hospital or clinic financial counseling role with knowledge of pre-authorizations and reimbursement regulations pertaining to Medicare, Medi-Cal, and children’s health programs, with previous experience working in a metrics-based environment driven by financial counseling goals (such as screening rates and collection goals).
Knowledge, Skills, and Abilities
· Language: Bilingual preferred (English and Spanish)
· Technology & Applications:
o Demonstrates proficiency as applicable with Epic, insurance websites, POS payment systems, web-based screening tools
o Knowledge and understanding of Microsoft applications (Word, Excel, PowerPoint)
· Industry Knowledge:
o Strong knowledge of eligibility and enrollment requirements for Medicare, Medi-Cal, Workers Comp, Managed Care (HMO, PPO, POS, etc ), Children's Health Programs (CCS, GHPP, Healthy Families, etc )
o Experience resolving issues in financial reimbursement billing, utilization management and government programs
o Prior experience calculating, communicating and educating patient’s on their financial responsibilities
o Demonstrated communication, customer relations, and organizational skills
o Ability to multi-task with attention to detail
o Ability to complete work efficiently and problem solve independently
o Ability to work well in a team environment
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