Specialist - Financial Counselling (SEHA Fertility Center)

Under the supervision of the Hospital Supervisor of Financial Counseling, the Financial Counselor serves as an advocate to uninsured and/or underinsured patients and their families, including making them aware of their estimated patient responsibility and informing them of payment options, including prompt pay discounts, payment plans, and UAE assistance programs. Financial Counselors also collect payments, review patient eligibility, and assist with the submission of financial assistance applications. This position will also be responsible for the collection of information and counseling of Self-Pay, Motor Vehicle Accident (MVA), THIQA Program, and International and noninsured patients at the time of service. The Financial Counselor will interview patients and families with regard to their ability to obtain payment for the hospital bill and helps to obtain coverage once they are discharged; assists families in applying for and dealing with third-party payor agencies regarding financial assistance. The position works with health insurance providers to determine coverage and benefit limits. Advises patients of procedure costs and alternative sources of funding. May arrange for referrals or second opinions. Relies on experience and judgment to plan and accomplish goals.

• Authorization, Verification & Eligibility
• Gathers documentation required for financial assistance applications;
• Maintains ongoing communication with government agencies regarding the status of claims, following up with patients as necessary to obtain required documentation to ensure that the state gets the info needed to process the applications in a timely matter;
• Adheres to hospital and legal standards regarding Protected Health Information (PHI);
• Runs a daily report, including the Registration by Location report to look for previous day self-pay patient registrations
• Work in collaboration with Patient Access and Pre-Admission Review staff to obtain demographic and insurance coverage information. Updating guarantor and subscriber information in the system as needed.
• Performs Real Time Eligibility (RTE) checks to confirm and or identify patient insurance coverage, reviewing the hospital’s Health Information System (HIS), and payer websites, as well as contacting patients, patient’s families, patient advocates, health care proxy’s, and physician offices when necessary;
• Provides updates and acts as a resource to hospital personnel including Patient Access, Case Management, and Social Services on financial matters as needed;
• Documents patient communications, the status of financial assistance applications, and payment plans in the hospital’s Health Information System (HIS);