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Modesto & Roseville, California
Longview, Texas
Easton, Maryland
Posted: 18-Nov-23
Location: Downey, California
Salary: Open
Categories:
Internal Number: 20830
The Financial Counselor ensures reimbursement to PIH Health from patients or other responsible parties and assists patients in understanding their health care insurance coverage by determining eligibility, benefits, authorization and utilization requirements and patient liability for specific department(s). The Financial Counselor is responsible for up-front collections and securing patients accounts by setting up appropriate financial arrangements with patients to avoid bad debt. The Financial Counselor, when appropriate, notifies patients of programs such as Medi-Cal, VVC, Uncompensated Care, Cobra coverage, Covered California and Hospital Presumptive Eligibility. Financial Counselors will focus on individual performance, Key Performance Indicators and expediting approvals by gathering and completing forms before the patient is discharged. Financial Counselors will continue to enhance their registration and the fundamental financial knowledge and skill set required and expected of this role, which is inclusive of the diverse financial program offered at PIH Health. ED & Urgent LDRP: Interaction with patients will only happen after a medical screening exam has been performed. All patients are seen regardless of their insurance coverage or their ability to pay.
PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services. The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.
- Demonstrates a clear understanding of PIH Health mission and values
- Ability to work directly with the insurance company, healthcare provider, and patients
- Ability to generate revenue with payment arrangements, collecting on accounts; monitoring and pursuing delinquent accounts.
- Legal Compliance knowledge and experience
- Demonstrated attention to detail and follow up process
- Demonstrated ability to communicate effectively and tactfully with patients, healthcare providers and insurance company
- Excellent English reading, comprehension and written skills to include spelling skills and penmanship
- Excellent Mathematical skills; ability to calculate and manage account figures and financial data
- Ability to follow directions as outlined in policies or given by supervisor
- Strong computer skills to include typing 45+ wpm minimum and in MS office programs
- Excellent organizational skills
- Ability to exercise independent judgment at times of need and emergency situations
- Bilingual preferred
- Interacts with all levels of hospital and outside vendor staff and knowledge of government regulations
- Strong analytical skills, problem solving. The ability to act and decide accordingly.
- Stringent adherence to all privacy policies and procedures and as required by state and federal law including and not limited to the HIPAA Security and Privacy Rules
- Minimum of two year experience in medical billing, front office and/or hospital registration/admitting
- Minimum of two year experience in insurance verification and/or front office, medical/hospital billing.
- High school graduate required or equivalent, prefer evidence of continuing education in Finance, Accounting or Business Administration
- Knowledge of eligibility requirements for Medi-Cal, Hospital Presumptive Eligibility Program, Medicare, Covered California, Cobra, limited benefit plans, VVC and Uncompensated Care Programs. IPA knowledge
- Medical terminology required
- Excellent communication skills
- Demonstrate flexibility in adapting to change
- Strong analytical skills, problem solving. The ability to act and decide accordingly.
