Description

Job Summary

Across multiple billing systems, the Financial Counselor diligently organizes bills, recovers, and resolves FHN’s open accounts receivables positioning FHN for solid cash performance. The Financial Counselor will utilize multiple tools and systems to analyze and execute the daily throughput (including the processing of approved account corrections) of revenue cycle billing and follow up, which includes quality assurance and issuance of insurance claims, client statements, and guarantor billing statements. This position has a direct correlation to the daily level of cash flow at FH. The in-depth field knowledge allows this level of talent to review and initiate self-pay collections, outline/identify options for patients to resolve their self-pay balances, and screen for financial assistance and public aid eligibility.

Job Responsibilities

• Process account corrections to ensure accurate and compliant billing upon partnering with HIM and hospital/practice leadership for direction.
• Performs in-depth analysis of daily client and claim files prior to electronic submission to payers for adjudication and payment remittance. Understands 1500/UB claim formats to make accurate corrections to claim errors in a timely manner and leverages electronic claim submission in all circumstances through the clearinghouse for prompt processing and reimbursement.
• Analyzes open self-pay AR and formulates follow up tactics to resolve “like account situations” (segmentation) to secure cash flow. Leverages business intelligence and the high-impact work lists that are built around self-pay accounts using electronic organization of open balances to obtain payment in full or payment plan. Complies with 501r, The Fair Billing and Collection Policy, and FHN Discounts and Financial Assistance Programs Policy.
• Assists in training of others and provides assistance to other teams.
• Communicates effectively and efficiently with patients over the phone or face-to-face assisting with questions ranging from insurance explanation of benefits questions to self-pay, financial assistance, or billing statements. Diffuses concerns and provides on the spot resolution. Counsel’s patients on residual self-pay balances – collecting balances in full, arranging an acceptable payment plan, identifying other funding sources, or applying the patient for financial assistance. Delivers timely throughput and resolution to customer questions and concerns.
• Utilizes reporting mechanisms to identify patients to set up an OB Contract and meet with the patient to explain and set-up the contract including preparing the estimated out of pocket the patient will be responsible for after delivery. Use business intelligence to identify and review self-pay accounts requiring an uninsured discount and apply the discount. Presumptively review acute accounts and presumptive write-off. Identify ED accounts for Crime Victim and Sexual Assault education and billing requirements. Prepare estimates for services upon patient request and in accordance with Federal No Surprise Act Regulations.
• Keeps abreast requirements for CPT, HCPCS and ICD-10 billing and other payer changes. Identifies, recommends, documents and rolls out process improvement opportunities to peers.

Qualifications

Requirements

Education: Associates Degree preferred

Required Experience: 2 – 5 years

Special Skills and Abilities:

• Medical Terminology
• Managed Care Structures/Contracting
• Coding Certificate
• Insurance Certificate
• Specialized Customer Service Training Courses

Licensure/Certification/Registration: HFMA CRCR (Certified Revenue Cycle Representative) required within 1^st year of hire

Populations Served

While performing this job, the employee may care for patients in the following age groups.

• Serves patients in areas other than direct patient care

While performing this job, the employee does not care for patients in the following age groups.

• No direct responsibility to treat or care for patients