Financial Counselor

About the position

Under indirect supervision, at the point of service provides financial counseling to patients in a personal interview to create a payer source for Inpatient and Outpatient self-pay accounts. Identifies potential third party liability, Workers Compensation, Commercial, COB, Medicare and Medi-Cal. Provides functional direction to Business Service Representatives and Receptionists. Determines and approves Medical Financial Assistance and payment arrangements.

Responsibilities

• Upholds Kaiser Permanentes Policies and Procedures, Principles of Responsibilities and applicable state, federal and local laws.
• Confidentially obtains or reviews and records patient financial and demographic information.
• Coordinates with inpatient/outpatient admission and registration for identification of potential alternate payer sources.
• Interviews patients to determine financial status, counsels and makes arrangements for direct payment, potential enrollment in a government sponsored program or direct billing to the patient.
• Completes Medical Financial Assistance applications based on analysis of patient financial information.
• Provides functional guidance to the support staff and informs support staff and physicians on new and revised processes.
• Acts as a patient/member advocate and uses knowledge of external and internal Social Services agencies for patient referral.
• Retrospectively reviews diagnosis and treatment records to identify potential Third Party Liability and Workers Compensation cases.
• Screens for potential eligibility for KP Membership through government programs (Medi-Cal, Medicare, transition plan, etc.).
• Obtains pre-authorizations for services from employers and other insurance carriers.
• Coordinates and collects conversion dues for KP coverage.
• Checks patient information against updated eligibility using on-line systems (Foundations).
• Places telephone call to the appropriate departments (CSC, Sales and Marketing etc.) in cases where group eligibility is not updated.
• Ensures that all documentation in the billable jackets is complete and obtains missing or needed information.
• Establishes and maintains courteous, cooperative relations with the public, patients, and other personnel.
• Performs other related duties as required.