The Patient Financial Counselor determines client eligibility for enrollment in available community programs including local funding and/or Medicaid. The Patient Financial Counselor is responsible for delivery of high-quality customer service with attention to special needs of a diverse client base. Employees must apply technical knowledge to analyze application materials to make appropriate decisions regarding client eligibility and ensure appropriate application of policies and procedures.
Requires fundamental knowledge of Conway Medical Center collection policies and procedures as well as other positions for Financial Assistance.
Collect all inpatient and observation out-of-pocket expenses while the patient is in-house. Out-of-pocket expenses include, but are not limited to deductible, co-payments, services excluded by insurance plan, and/or self-pay negotiated amount due.
Timely and accurate review of Charity Pending requests, request for copies of Itemized bills or claims, and incoming mail.
Responsible for following up on all Financial Assistance requests through email/Patient Portal/telephone.
Assist patients with the application process to include the Heath Exchange Program.
Schedule appointments with patients to collect financial statements, unemployment, social security, and any other funding.
Greet all patients and their accompanying family members when applicable and provide exemplary customer service.
Coordinate with outside agencies for the patient qualifications of Conway or the State of South Carolina.
Serves as a source for patients that exceed the Health Care District Coordinated Care FPLG (Federal Poverty Level Guidelines) but meets Charity Care FPLG.
Interview people in need of services and assist them in navigating the documentation process.
Must possess knowledge of Medicare, Medicaid, HMO, PPO, and Commercial guidelines.
Review inpatient and observation admissions for adequate payer source and establishes a plan to secure payment resources to maximize hospital reimbursement.
Work effectively and collaboratively with colleagues, physicians, and department heads.
Effectively utilize strong organizational skills.
Consistently display effective verbal communication skills.
Proficient understanding and use of technology/PC skills required.
Regularly exercise independent judgement.
Complete other duties as assigned by department leadership.