Financial Counselor - Admitting

By joining our team, you'll be part of our life-changing Mission and Vision. You'll work in a truly inclusive environment where diversity and equity are championed through words and actions. You'll contribute to an innovative culture that is second to none, one that embraces curiosity, discovery and compassion. You'll play a role in something that's never been done before as we integrate science and clinical care to help patients achieve better, faster outcomes - as we Advance Human Ability, together.
Job Description Summary
The Financial counselor is responsible for providing patients with a positive financial experience by helping patients navigate and understand insurance benefits and potential financial liability. The Financial Counselor is the patient's point of contact for financial assistance questions prior to and at admission.
The Financial Counselor advises patients in person and over the phone on their insurance benefits and coverage, and in some cases, assesses patient referrals for appropriateness. The incumbent assists patients with eligibility for government programs, Shirley Ryan AbilityLab financial assistance program, and other options for managing high medical liabilities. Independent judgment and decision making is required to address the full range of tasks and responsibilities. The position requires the ability to plan, schedule and organize numerous tasks that directly impact hospital and physician reimbursement.
The Financial Counselor will facilitate activities around complex inpatient admissions including expediting response to referral inquiry, insuring benefits are available to cover admission, obtaining insurance authorization for admission, obtaining social and demographic information to support compliance and discharge plan. Analyzes clinical, financial and socio-demographic information to direct referral to appropriate level of care. Communicates necessary information to Patient Financial Services, admission liaisons, care teams, and care managers.
The Financial Counselor will consistently demonstrate support of the Shirley Ryan AbilityLab statement of Vision, Mission and Core Values by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute.
The Financial Counselor will demonstrate Shirley Ryan AbilityLab Core Attributes: Communication, Accountability, Flexibility/Adaptability, Judgment/Problem Solving, Customer Service and Core Values (Hope, Compassion, Discovery, Collaboration, and Commitment to Excellence) while fulfilling job duties.
Job Description
The Financial Counselorwill:

• Assist with coordination of benefits, family appeals, and interpretation of benefit coverage for complex cases, including out of network determinations. Assist intake coordinator with identifying and coordinating GAP agreements and other related agreements.
• Communicate directly with patient/family, as needed, prior to admission, to clarify any benefit limitations. Communicate financial denials for inpatient admission to referral source and patient or family when appropriate.
• Provides rationale and recommendations for alternate care when communicating denials.
• Enter patient demographic, insurance, funding, and medical information in medical record as appropriate.
• Identify and confirm patients at increased risk for a change in coverage during inpatient stay including transition to Medicare, change in employer related benefits or coverage termination for example cobra payments, and short and long term disability to confirm how insurance payments are received. Upon admission, obtain information from patient/family to address any outstanding insurance issues.
• Research and verify patient payment coverage by accessing electronic payer data bases, conferring with third party payors, case managers, attorneys, Patient Financial Services, and public aide applications, expediting to consultant and other parties involved in third party payment for medical expenses. Through batch eligibility process and in partnership with care management, identify and address any change in benefit coverage during inpatient stay. Pursue retro-authorizations as necessary.
• Notify manager and director, as appropriate, of any issues which would be considered unusual or extraordinary.
• Communicate necessary information to Patient Financial Services, care teams, care managers, admission liaisons, central supply staff via the Information System (Cerner) email and telephone to support excellent customer experience.
• Utilize decision making skills to be accountable for pending, current and discharged cases. Correct any inaccurate data found on audits of the encounter.
• Promote Shirley Ryan AbilityLab services in communication with referrers, patients, family members and insurance representatives in telephone communication, meetings and tours of the Institute.
• Perform the above responsibilities independently and in close collaboration with the Manager, Inpatient Financial Clearance and with the Intake Coordinators.
• Train and precept Senior Intake coordinators on financial counselling, and assist in training intake coordinators on financial clearance skills as needed. Perform all other duties that may be assigned in the best interest of Shirley Ryan AbilityLab.

Reporting Relationships

• Reports directly to the Manager, Inpatient Financial Clearance

Knowledge, Skills & Abilities Required

• Work requires level of knowledge typically acquired through completion of a Bachelor's degree in business, social work, health care administration or related field.
• Two to five years previous experience in financial counselling, and health care financial clearance is preferred for knowledge of common insurance plans and limitation, knowledge of Medicare and Medicaid plans and rules.
• Knowledge of patient admission, registration procedures, benefits, and financial clearance procedures.
• Strong customer service skills and interpersonal skills necessary to interact with all levels of personnel, physicians, insurance representatives and referrers, and especially to interact with patients and families.
• Analytical skills necessary to ensure referrals, financial clearance and admissions are managed in compliance with standards and to identify unusual circumstances that could put the patient/family or the Institute at financial risk.
• Excellent time management skills to meet or exceed department expectations and to prioritize tasks to support timely patient admission.
• Excellent teamwork skills to ensure successful collaboration with physicians, other admitting staff, admission liaisons, Global Patient Services staff, care managers, PFS staff and other co-workers.
• Working knowledge of Windows operating environment and Microsoft Office software applications.

Working Conditions

• Normal office environment with little or no exposure to dust or extreme temperature. Ability to independently move across long distances within the organization to meet with patients, families and staff.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
Equal Employment Opportunity
ShirleyRyan AbilityLab is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.