Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Financial Counselor in Santa Rosa, California

We are looking for a Financial Counselor with Patient Finance_Area at Santa Rosa Memorial Hospital.

Location: Santa Rosa, CA

Schedule: Full Time - 80 biweekly hours

Shift: 8-hour Days

Job Summary:

The ministry's resource for knowledge on all government programs and financial assistance options. Responsible for maintaining thorough knowledge of all programs and shares information with Patient Access Specialists. Follows up on pending applications for any program and works with vendors and government agency representatives to ensure timely and accurate resolution of pending cases. Handles certain applications for highly specialized and complex programs from inception through to approval, if not handled by a vendor. Works closely and regularly with Case Management to follow up on in-house patients whose financial situation is unclear or has changed, since the time of admission. Serves patients in a professional, friendly, and respectful manner.

Essential Functions:

  • Maintains a current knowledge of all government and community financial assistance programs, including eligibility and application process. Gains and maintains a deep and thorough knowledge of all specialized government programs and acts as a resource on details to all Patient Access staff, Case Management staff, and other clinicians.

  • Performs financial screening on self pay patients to determine potential eligibility for financial assistance. Counsels patients regarding potential financial assistance eligibility and the process for application. Assists patients with the completion of the financial assistance application process.

  • Performs other complex financial counseling functions (e.g. extended payment arrangements, discounts).

  • Follows up on patients who have applied for financial assistance and have not submitted completed forms. Reviews completed financial assistance applications for accuracy and makes initial approval determination.

  • Follows up on patients who have applied for Medi-Cal or other government programs and have not submitted completed forms. Refers patients to the government eligibility vendor when potential eligibility is identified.

  • Monitors work of the eligibility or other vendors to ensure complete and timely resolution of cases and refers to supervisor, when vendor work is incomplete or untimely.

  • Supports work of eligibility or other vendors by obtaining medical record or other clinical documentation to complete applications, where necessary.

  • Handles all applications for complex financial assistance programs, e.g. California Children's Services from the point of application through to approval.

  • Works with representatives from government agencies, including on site workers, to ensure speedy resolution of cases pending approval and provides any needed documentation to the agency representatives.

  • Meets regularly with Case Management to review status of in-house patients and takes action to ensure that patients with less than full financial coverage receive financial counseling.

  • Collaborates with Nursing Units and Care Management to determine patient’s medical and mental condition prior to visiting patient in room. Patient’s who cannot meet are documented and a follow up visit is performed daily. Visits patients in patient room to discuss insurance benefits and payment options including past balances or bad debt.

  • Alerts immediate supervisor of potential patient counseling issues. Answers any question posed by a patient related to a billing or financial issue. Documents all communication with patient, payer and/or Care Management in Meditech notes.

  • Exceptional customer service skills:

  • Able to cordially, professionally and effectively interact with patients, family members, physicians and other hospital personnel in a fast-paced environment.

  • Able to relay complicated information from patients or family members to clinical staff.

  • Able to handle potential difficult patients/families/customers, physicians/clinical staff, and internal staff.

  • Work independently, be self directed and work effectively with individuals that have a wide diversified background.

Skills:

  • Typing and basic computer skills to include: Internet Explorer, Microsoft Outlook, Microsoft Word and Microsoft Excel. Ability to handle cash and credit/debit card transactions, including collecting and refunding payments to patients. Ability to balance cash drawer at end of shift. Ability to navigate Health Plan Websites.

  • Knowledge with insurance eligibility systems including Medicaid (Medi-Cal), Medicare and other commercial and private payer eligibility systems.

  • Excellent knowledge of applicable rules/regulations/guidelines governing Managed Care and Government sponsored coverage and reimbursement.

  • Excellent verbal and written communication skills.

  • Exceptional customer service skills. Candidate must be able to cordially, professionally and effectively interact with patients, family members, physicians and other hospital personnel in a fast-paced environment.

  • Ability to work in a team environment.

  • Knowledge of medical insurance and types of payer benefits.

  • Bilingual – fluent in English and Spanish preferred.

  • Knowledgeable of bill codes (DRG, ICD-9, CPT, HCPCS, etc.) preferred.

Position Requirements:

Education:

  • H.S. Diploma or GED

Experience:

  • Two (2) years Hospital experience specific to patient registration, insurance verification, financial counseling or Business Office.

Preferred Position Qualifications:

Education:

  • Associate's Degree in Health Care or Business Administration.

Experience:

  • Experience in self-pay and third-party collections.

  • Experience utilizing medical terminology in job setting and a basic understanding of insurance requirements.

  • Experience with Meditech/A4 system.

License/Certification:

  • CHAM certification through the National Association of Healthcare Administrative Managers (NAHAM)

Providence St. Joseph Health (Providence) has worked for decades to improve health and quality of life in California's North Bay region, starting in Sonoma County, where the Sisters of St. Joseph of Orange opened the doors of Santa Rosa Memorial Hospital in 1950. Today, we continue the mission begun by the Sisters to those we serve through an integrated spectrum of primary, urgent, acute, outpatient, palliative care and regional referral services. Sonoma County facilities aligned with Providence include the 278-bed Santa Rosa Memorial Hospital, the region's only Level II trauma center. In addition, the 80-bed Petaluma Valley Hospital and 43-bed Healdsburg Hospital are secular (non-religious) affiliates of Providence. Our services also encompass three Urgent Care centers, Hospice of Petaluma, Memorial Hospice and North County Hospice, the Annadel Medical Group doing business as St. Joseph Health Medical Group, as well as the St. Joseph Home Care Network (post-acute care services). We act as a regional referral hub for outlying hospitals, while also providing outpatient behavioral health care, education to promote health and prevent chronic disease, rehabilitation, oral health care, community benefit programs, and more, all fostering health and quality of life throughout the area.Providence provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Providence complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.Positions specified as "on call/per diem" refers to employment consisting of shifts scheduled on as "as needed basis" to fill in for staff vacancies.

Company: Sonoma County Entities

Category: Patient Access

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