National Association of Latino Healthcare Executives ยท 12 hours ago
Financial Counselor
Moreno Valley, CA
Full-time
Onsite
New Grad, Entry LevelThe National Association of Latino Healthcare Executives is dedicated to enhancing healthcare access for Latino communities. They are seeking a Financial Counselor to ensure accurate documentation of patient membership status and resolve patient liabilities at the point of service, while also providing financial counsel to patients regarding payer sources and health plan benefits.
Health CareHospitalMedical
Responsibilities
Confidentially probes patients who have been referred by staff such as inpatients/outpatient registration, department administrators, physicians, nursing, utilization management and social workers about the nature of their problems as they may concern the ability to have services covered by an alternate payer (Non-member, Coordination of Benefits, Third Party Liability, Workers Compensation) or issues dealing with membership
If the patient is determined to be ineligible, uses independent judgment to identify an alternate payer or identify the patient as medical indigent
Uses knowledge of Workers Compensation, Commercial Insurance Plans, Third Party liability, outside agencies, and governmental regulations for government programs; patient interview and observation; analysis of financial data; and physicians notes in order to accurately identify an alternate payer
Skillfully probes patients about their financial status, counsels and make arrangements for direct payment, status as an indigent, potential enrollment in a government sponsored program, or direct billing to patient
If the patient is determined to be indigent and not be able to qualify for any governmental program, completes a Kaiser Permanente medical Financial Assistance application and based on analysis of patients financial information, approved medical; Financial Assistance up to $2,000 value or recommended approval to supervisor when amount exceeds $2,000
Determines patients ability to pay based on analysis of patients financial information and negotiates and approved payment arrangements based on patients financial status
Provides functional guidance to the support staff and trains support staff and physicians on new/revised process
Acts as a patient/member advocate and uses knowledge of external and internal social service agencies to accurately refer patients to social services
Retrospectively reviews diagnosis and treatment records to identify potential Third Party Liability and Workers Compensation cases
Refers identified cases to the Billing Department
Screens for potential eligibility for Kaiser Permanente membership through Government Programs (Medi-Cal, Medicare, transition Plan, etc.) and refers to Member Services
Obtains pre-authorization for services from employers or other insurance carriers
Coordinates and collects conversion dues for Kaiser Permanente
Checks patient information against update eligibility using on-line systems
Places telephone calls to appropriate departments (Membership Accounting, Sales and Marketing, etc.)
Ensures that all reviewed documentation in the billable jacket or on the superbill is complete and obtains any missing or needed information
Promotes, ensures, and improves customer service to internal/external customers by demonstrating skills which are consistent with the organizations philosophy of providing extraordinary customer relations and quality service
Qualification
Required
Ability to confidentially probe patients about their financial status
Knowledge of Workers Compensation, Commercial Insurance Plans, Third Party liability, outside agencies, and governmental regulations for government programs
Skill in analyzing financial data and physicians notes to accurately identify an alternate payer
Ability to counsel patients and make arrangements for direct payment or enrollment in government sponsored programs
Experience in completing financial assistance applications and negotiating payment arrangements
Ability to provide functional guidance and training to support staff and physicians
Knowledge of external and internal social service agencies for patient referrals
Experience in retrospectively reviewing diagnosis and treatment records for potential Third Party Liability and Workers Compensation cases
Ability to screen for potential eligibility for Kaiser Permanente membership through Government Programs
Experience in obtaining pre-authorization for services from employers or other insurance carriers
Ability to check patient information against update eligibility using online systems
Experience in ensuring that all reviewed documentation is complete and obtaining any missing information
Demonstrated skills in providing extraordinary customer relations and quality service
Company
National Association of Latino Healthcare Executives
The National Association of Latino Healthcare Executives is a hospital and healthcare organization.
Founded in 2005
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Jackie Sifuentes, MBA, LSSYB
Co-Founder La Mesa Emerging Leaders Mentorship Program for Early Careerists
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