Providence MAP Financial Counselor (Full-Time, Days) in Portland, Oregon
Providence is calling a MAP Financial Counselor (Full-Time, Days) to our location in Portland, OR.
The MAP Financial Counselor Gatekeeper proactively evaluates and interviews patient/guarantor to capture and understand key financial data including estimated coinsurance to determine the patient’s general financial situation and ability to pay for balances due or qualify for financial assistance. Provides extensive knowledge of financial, insurance, and payment information of various community and PHS resources to offer patient in resolving account balances (e.g. federal programs, Medication Assistance Program, etc.) with a focus on hospital outpatient infusion services. The incumbent performs all duties in a manner that promotes the Providence mission, values, and philosophy. In all aspects, the incumbent serves as a role model for the values and mission of the organization.
In this position you will:
Proactively evaluates and interviews patient/guarantor to capture and understand key financial data including estimated coinsurance to determine the patient’s general financial situation and ability to pay for balances due or qualify for financial assistance.
Provides extensive knowledge of financial, insurance, and payment information of various community and PHS resources to offer patient in resolving account balances (e.g. federal programs, Medication Assistance Program, etc.) with a focus on hospital outpatient infusion services.
Takes ownership of accounts and prioritizes incoming cases and work-in-process caseload, using principles of stratification and Epic work queues.
Reviews, estimates and interprets billing statements charge information, private or government insurance benefits, and other related information and connects patients with drug manufacturer copay assistance or other programs and resources.
Provides education to customers (patient, physician) and peers (discharge planners, etc) regarding insurance benefits, managed care contract discounts and payment systems (DRG, Flat Fee, Per Diem, Charge Based) especially those pertaining to hospital outpatient infusion services.
Facilitates completion of Medicaid and OHP applications, eligibility and receipt by the state.
Provides education regarding charges and billing information to patients or insurance companies.
Escalating charge discrepancies as appropriate to RBO contacts for care department review.
Assist customers (patient, physician clinic) in contacting third party providers or insurance companies to resolve issues as appropriate.
Negotiates payment arrangements, determines financial assistance limits up to $7000 and/or sets up payment plans.
Resolves complex patient issues and concerns that present at the on-site office, and communicates with the RBO in order to help resolve issues, as appropriate.
Acts as resource to Access Services, physician offices, quality assurance organizations, clinical departments, and other Providence Health System entities concerning the resolution of patient concerns in financial matters.
Escalates problematic or high-risk accounts to supervisor for assistance.
Required qualifications for this position include:
High School Diploma or GED equivalent
Three (3) years experience in Financial Counseling, patient financial services or medical billing in a hospital Business Office
Experience in automated/computerized account follow up system(s)
Preferred qualifications for this position include:
College coursework in medical terminology, medical billing or a related medical business field
Experience with medical and health plan terminology and medical necessity requirements, CPT codes and ICD-9 coding
About the department you will serve.
One Revenue Cycle (ORC) is the name adopted to reflect the Providence employees who work throughout Providence in revenue cycle systems and structures in support of our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. ORC’s objective is to ensure our core strategy, One Ministry Committed to Excellence, is delivered along with the enhanced overall patient care experience (know me, care for me, ease my way) by providing a robust foundation of services, operational and technical support, and the sharing of comprehensive, relevant, and highly specialized revenue cycle expertise.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Patient Services
Req ID: 279552
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