Financial Counselor - UH Patient Access - University Hospital

Job description

Overview
USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community. USA Health is changing how medical care, education, and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists, and researchers provides the region's most advanced medicine at multiple facilities, campuses, clinics, and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall well-being of our community.
Responsibilities
• Assesses treatment orders/protocols to determine oncology costs of patients' total treatment and provides estimates of future services;
• Utilizes electronic system to review individuals' insurance policy/coverage in determining patient obligations for payments;
• Explains financial requirements to the patient or responsible party and collects deposits, deductibles, or coinsurance as required;
• Advises patients of balances due;
• Interacts with patients by telephone, e-mail, or in person in a professional and courteous manner to communicate financial expectation prior to receiving service;
• Utilizes databases to research incorrect patient demographic information;
• Documents all activity;
• Collects appropriate payment before services are performed, if satisfactory arrangements are not made;
• Works with physicians' office staff, physicians, departmental directors and management to determine whether services can be postponed until financial obligations are met;
• Reschedules patients in computerized scheduling system as needed;
• Collects appropriate payment before services are performed, if satisfactory arrangements are not made;
• Provides information regarding payment requirements, alternative financing. and charity care programs that patients may be eligible for and that meet all applicable guidelines;
• Works closely with billings staff to ensure all information is collected to ensure timely billing;
• Coordinates appeals of insurance payment rejections with the business office;
• Coordinates appeals of insurance payment rejections with the business office;
• Stays current with respect to changes in regulatory statutes, major insurance plans, deductibles, coinsurance, and non-covered services and state legislation;
• Demonstrates an understanding of insurance reimbursement, Medicaid eligibility and available patient financing programs;
• Interacts with patients, physicians, faculty, staff, and administrators and outside entities in a professional manner;
• Utilizes excellent customer service skills for internal and external customers;
• Maintains HIPAA requirements in all areas;
• Utilizes Microsoft Word and Excel to prepare correspondence and reports;
• Completes all mandatory department, educational and hospital requirements
• Adheres to current Infection Control and Safety Standards
• Regular and prompt attendance
• Ability to work schedule as defined and overtime as required
• Related duties as assigned

Additional Information
Employees must be in a regular position, working 20 hours or more per week (.50 FTE or greater) to qualify for benefits.
Qualifications
• High School Diploma or equivalent and 4 years of medical business office or medical insurance experience Required
• Higher education in Social Work, Counseling, or directly related field may substitute on a year-for-year basis for the required experience. Required
• Comparable combination of education and experience may substitute for the above requirements.

Knowledge, Skills, and Abilities
• Familiarity with medical terminology is required. High
• Insurance and Healthcare Billing: Deep understanding of commercial insurance, Medicare, Medicaid, Managed care plans, precertifications, deductibles, co-pays and out-of-pocket maximums. Medium
• Financial Assistance Programs - Knowledge of hospital Charity care policies, sliding-scale fee programs, state/federal aid and philanthropic grants and programs Medium
• Compliance and Regulations: Awareness of healthcare privacy laws (HIPAA), financial counseling regulations, and fair debt collection policies. High
• Communication & Negotiation: Ability to explain complex medical bills, insurance policies and payment terms in clear accessible language. High
• Analytical and Assessment Skills: Proficiency in evaluating household income, reviewing financial documents and calculating realistic deposits and/or patient payment plans. Medium
• Empathy and De-escalation: Ability to effectively handle high-stress, emotionally charged conversations with patients and families facing unexpected medical debt or illness, with care and concern. High
• Time Management and Multi-tasking: Capacity to balance high-volume patient walk-ins, phone inquiries and back-office billing follow-ups. High
• Ability to interact respectfully and effectively with a diverse patient population from varied socioeconomic and cultural backgrounds. High

Equal Employment Opportunity/Affirmative Action Employer
The University of South Alabama is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, pregnancy, sexual orientation, gender identity, gender expression, religion, age, genetic information, disability, protected veteran status or any other applicable legally protected basis. EO Employer – minorities/females/veterans/disabilities/sexual orientation/gender identity.