Tufts Medical Center Financial Counselor in Boston, Massachusetts
Department: Financial Coordination
Schedule: Full-Time Regular
Shift: Rotating shifts w/ occasional weekends
Hours: M-F 8-4:30, but can vary with weekends needed
Bachelor's degree is preferred
1-2 years experience is required
Under general supervision, interviews all assigned inpatients and becomes the patient's coordinator for all billing and/or financial concerns for the Hospital and both of the professional billing services. Works in tandem with a Clinica1 Case Manager to provide financial guidance to the primary care core clinicians regarding patients in their case load. Makes determination regarding eligibility for all public assistance programs and ensures that applications are completed accordingly. Arranges and collects deposits from patients who will have a personal financial liability .
Contacts in person, over the telephone, or via correspondence, 100% of the inpatients assigned in the case load. In the case of emergent admissions, such interview may occur at the patient bedside.
Coordinates for the patients assigned in the case load all billing and financial issues related to the admission for both the Hospital and the physician billing services. Acts as point person for the patient for all billing and financial questions regarding the admission, prior to, during, and after the hospital stay.
Obtains all demographic and insurance information within 24 hours of scheduling or admission to ensure accurate and prompt third party payments to both the Hospital and the professional billing services.
Ensures that all demographic and insurance information is communicated appropriately to both Hospital and professional billing services to ensure prompt and accurate third party payment.
Resolves all self-pay liabilities for both the Hospital and professional groups. Resolution may mean collection of cash, establishment of payment plans, eligibility for numerous state/federal financial assistance programs and/or qualification for free care or other debt forgiveness, per the guidelines of the Hospital and each professional group.
Completes, files, and follows to resolution applications for Welfare, DSS, SSI, Healthy Start, Commonhea1th Children's Security Plan, and other such programs. Analyzes both financial and medical documentation to determine probable eligibility. Completes and follows through to completion applications for free care.
Refers patients to programs where Hospital staff cannot file directly for the patient, including Veteran's Services, and EAEDC.
Works closely with the Clinical Case Manager to provide financial input to decisions and activities under purview of QSS. The Financial Case Representative and Clinical Case Manager, working in tandem, provide a cohesive support system to the primary care providers.
Provides information and direction to other clinical staff personnel, including Social Work, Nursing, Pharmacy, etc.
Learns and keeps up to date with the myriad of regulations for the many social programs listed above, so that applications are appropriate and complete so that both the Hospital professional groups and the patient receive all benefits for which the patient is eligible.
Level knowledge generally acquired through completion of a Bachelor's degree with courses in business management or social sciences or comparable experience.
Two to three years experience in a community service environment such as a Hospital or Welfare Agency.
In-depth knowledge of medical terminology and its relationship in establishing certifiable disabilities.
Excellent interpersonal skills required to interact effectively with patients, their families, the medical staff, QSS, and other departments within the facility, as well as many outside agencies.
Ability to grasp, retain, and apply new regulations and procedural changes both within the institution and to outside agencies.
Complete understanding in the application of health insurance benefits to hospital and professional charges.
Ability to handle stressful situations involving critically ill patients and other sensitive issues which involve finances.
Good written communication skills.
Excellent systems skills. Ability to work in a complex systems environment and understand spreadsheets and other business technologies.