FINANCIAL COUNSELOR

Position: FINANCIAL COUNSELOR
Location: Milwaukee, WI

Job Summary:

For patients who are identified as self pay, claim financial hardship or the inability to pay, initiates timely account resolution activities to address the issue while attempting to allow elective patient care to proceed as scheduled.

Job Responsibilities:

• -Monitors applicable Financial Counselor work queues to ensure that all initial patient financial activities have been completed, and that account balances that have not been previously secured through insurance verification or other confirmed subsidy sources are addressed in a timely manner.
• -Reviews Financial Counselor work queues on an ongoing basis to ensure payment source has been secured for all discharged self pay patients when applicable.
• -Updates the patient accounting system as activities have been completed and as patient account problems and issues have been addressed, in accordance with Patient Financial Services policies/procedures.
• -Counsels with patients to guide them through the application and eligibility process with Medicaid offices, Victim of Crime, Insurance Exchange, and other resources available to patients to cover Health services.
• -Assists patients with the Financial Assistance application process according to the protocols set forth in , Community Physicians, and Medical College of Wisconsin Financial Assistance policies.
• -Based on the patient's ability to pay and the urgency of medical need, collects patient deposits after estimating the approximate costs of the anticipated care.
• -Calculates, provides, and updates estimates upon necessity to various staff and patients. Calculates, provides, and updates estimates upon request to various staff, patients, and other potential customers.
• -Communicates with Social Services, Case Management, Admitting/Registration, appropriate department personal, and the physician as applicable to discuss those patient financial problems that cannot be resolved to determine the alternatives to the elective patient care plan.
• -Enforces hospital patient accounting and compliance processes by confirming that required documents have been completed, insurance (re) verification has been performed, and precertifications/re-certifications have been obtained.
• -Cross trains and provides backup coverage for all Financial Counselor positions as determined by the Team Coordinator or Patient Financial Services Manager to ensure adequate Financial Counselor coverage for all areas within department.
• -This includes shifts extending into the PM shift and weekend or holiday coverage.
• -Assist patients during open enrollment period to apply for a Qualified Health Plan (QHP) and/or Insurance Affordability Programs.
• -Adhere to document storage & destruction policies/procedures.
• -Adhere to all state and federal regulations along with  policies/procedures pertaining to the Certified Application Counselor responsibilities.
• -Stay current on all regulatory updates and policy/procedure changes pertaining to Certified Application Counselors at Health.
• -Other duties as assigned.

Required

• HEALTHCARE/REVENUE CYCLE FUNCTIONS
• CASE MANAGEMENT
• SOCIAL WORK
• PATIENT ACCOUNTING SYSTEM
• FINANCIAL ASSISTANCE APPLICATION PROCESS

Additional

• INSURANCE VERIFICATION
• PRECERTIFICATIONS
• RECERTIFICATIONS
• QUALIFIED HEALTH PLAN
• INSURANCE AFFORDABILITY PROGRAMS
• MICROSOFT WORD
• EXCEL
• EPIC

Required Skills & Experience:

• -A minimum of one (1) year of experience in healthcare/revenue cycle functions (or other business office), case management, or social work.
• Preferred Skills & Experience:
• -Experience using Microsoft Word, Excel and other software programs.
• -Experience using Epic in a healthcare environment.
• -Experience in social work or case management.

Required Education:

• -High School diploma or equivalent.

Preferred Education:

• -Bachelor's degree in social work, case management, healthcare administration, business administration, or other related field.

Preferred Certifications & Licensure:

• -State of Wisconsin and Federal Certified Application Counselor Designation.
• -In lieu of Certified Application Counselor Designation, current Licensed Health Insurance Agent.

Certifications & Licenses:            

Licensed Health Insurance Agent

State of Wisconsin and Federal Certified Application Counselor Designation