Patient Financial Counselor

Geisinger; State College (Centre County); On-site; USD 42,000 - 64,000; Full time

Job summary

Geisinger in the United States seeks a Patient Financial Services professional to interview and guide patients through financial obligations, Medicaid eligibility, and insurance benefits to enable care, admissions, surgeries, and outpatient services. The role involves counseling, coordination with multiple departments, and ensuring compliant billing practices.

The position requires strong communication, problem-solving, and ability to manage accounts receivable and payment plans while

Responsibilities

• Interviews patients to determine financial obligations and discuss payment options
• Discusses price of care and patient financial situation with patients to resolve accounts
• Serves as advocate educating patients on financial matters and expected outcomes
• Provides back-up support across Revenue Management departments and related units
• Coordinates between Revenue Management teams, Practice Consultants, Utilization Management, Care Management, providers and departments to manage financial counseling activities
• Calculates patient balances and negotiates payment plans or other arrangements
• Performs accounts receivable review for special pricing and ensures correct allocation of funds
• Promotes day-of-service cash collections and collection of outstanding balances system-wide
• Prepares pre-service price estimates and educates patients on insurance benefits and mutually agreeable terms
• Maintains records in Electronic Medical Record systems and adheres to billing guidelines
• Identifies opportunities, prepares reports and communicates findings and recommendations
• Resolves accounts via charity, vendor referrals, or other Revenue Management policy options
• Advises supervisor on unusual situations and ensures compliance with applicable billing requirements
• Executes work in a way that aligns with the revenue lifecycle interactions across units
• Assists physicians, insurance companies, and others with financial clearance and patient account requests
• Coordinates with other departments to resolve financial clearance, insurance, billing and collections concerns
• Maintains ability to manage assigned projects and tasks related to Revenue Management efforts

Job description

• Interviews patients with inadequate and no insurance coverage to obtain suitable financial arrangements prior to the services being rendered, when applicable for admissions, in and out surgeries and outpatient clinical departments.
• Follows Revenue Management policies and procedures regarding financial matters and payment arrangements.
• Conducts detailed discussion with patients, obtains information and completes required tasks to determine patient’s eligibility for Medicaid and other federal, state, and local government or private sources as appropriate.
• Meets with patients on a one-on-one basis to discuss the price of care and patient’s current financial situation, obtaining all pertinent demographic and financial data to ensure resolution of account. Serves as an advocate to the patient to educate them on what to expect regarding financial matters.
• Responsible to be personally available to answer patient questions pertaining to financial, billing, and account status. Takes ownership of a customer’s problem and ensures the matter is resolved timely and that the customer is satisfied with the solution.
• Provides oversight for assigned department and may be the first point of contact for the department regarding Patient Financial Services.
• Able to provide back-up support and coverage for any department as well as provide report analysis to departments and areas not covered by a Coordinator.
• Acts as coordinator between all Revenue Management teams and departments including Practice Consultants, Utilization Management and Care Management, Providers, Geisinger departments, clinical departments, and the patients concerning financial counseling activity.
• Calculates patient’s outstanding balances and then discusses and finalizes the method of resolving those balances through pre-service financial counseling, point of service collections, payment plans, or other arrangements.
• Performs accounts receivable review for special pricing packages and ensures appropriate allocation of funds.
• This includes the ability to identify areas of opportunities and provide trending information and detailed documents outlining findings and recommendations.
• Prepares receipts for payments collected (both past and future). Promotes day of service cash collections and collections of outstanding balances system wide.
• Requests and assists patients by preparing pre-service price estimations, educating patients on insurance benefits, and arranging mutually agreeable payment terms.
• Conducts research and follow-up activities on assigned accounts according to established procedures and time frames.
• Assists in maintaining control of self-pay accounts receivables.
• Resolves accounts via charity, vendor referrals, financial status determination, and other options as defined by Revenue Management policies and procedures.
• Performs troubleshooting activities surrounding Revenue Management financial advising and service issues and trends for assigned service lines.
• Maintains ability to manage assigned projects and tasks associated with these efforts.
• Assists physicians, insurance companies, employers, and others with requests concerning financial clearance and patient accounts to result in positive resolution.
• Coordinates efforts with other departments to resolve financial clearance, insurance, billing, collection, and other related concerns and issues.
• Completes and updates Electronic Medical Record for all patients interviewed, via billing systems and Geisinger approved guidelines.
• Advises supervisor of unusual situations, chronic financial, medical, and legal problems.
• Ensures compliance with federal, state, and other third-party billing requirements.
• Position executes work functions while demonstrating a global knowledge of how their work interacts with other units in the revenue life cycle.

Work is typically performed in a clinical and office environment. Travel may be required. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.