Pt Financial Cdtr/Cert App Counselor - Team B

Position Summary:

The PFC assesses patient's financial and insurance information in order to determine Medicaid, or other Community Resources. Facilitates the actual insurance enrollment processes; manages accounts that require a detailed, large scope analysis of payment/insurance options in order to secure reimbursement. Receives account referrals from Pre-access, Patient Access, CBO and others for high deductible, out-of-pocket expenses, unresolved or pending claims and other financial risk issues.

Qualifications:

Educational Requirements

Education Level

Concentration/Major

Associate's Degree

Health related field



Licensure/Certification Requirements

Licenses/Certifications

Licenses/Certification Details

Time Frame

CMS Exchange Certification

DH Presumptive Certification

within 1 Year

Specialized Knowledge and Skills Requirements

Knowledge of Insurance/Medicaid

Essential Functions:

Essential Functions

Counsels patients via phone or in person, reviews patient's previous accounts for outstanding balances, and financially counsel patients on all options of payments.

Monitors and works, on a daily basis, all self-pay accounts from assigned work queues

Assess patients financial/insurance information in order to determine insurance eligibility

Follow up with the Department of Human Services and all other Public Agencies regarding application process

Reviews Department of Human Services decisions for enrollment in applicable states; ensures all follow-up has been completed for the patient

Completes and submits Medicaid for patients that may potentially qualify in a timely and accurate manner

Facilitates Medicaid patient's documents for non-universal charity eligibility sent to the CBO

Explains payment options, Carle collection processes and accepts payments directly from inpatient and all patients from both the hospital and clinics

Updates patient Medicaid information in Epic and communicates changes to appropriate parties

Assist Patient Registration in the registration process of patients



Department Specific Job Function

Interact in a professional and compassionate manner to ensure patients and their representatives needs are met and that they understand the hospital's financial policy.

Increases Carle Health staff communications, accuracy, productivity, cohesiveness and continuity system wide while improving direct communication with the CBO regarding patient's financial obligations

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.

Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.