Position Summary: 

The Single Billing Office Financial Counselor is responsible for interacting with patients in person or by phone to ensure all avenues of reimbursement or assistance are pursued to guarantee payment for uninsured and underinsured patients. The financial counselor must use sound judgment and decision‐making skills to ensure that all options for resolving open patient balances have been pursued.   Duties include counseling of patients with respect to patient billing policies, payment arrangements in compliance with self‐pay payment arrangement guidelines and eligibility of governmental need‐based programs as appropriate. The financial counselor gathers the required documentation to determine patient responsibilities for specified office and hospital based procedures and confirms that all processes related to insurance eligibility and verification utilizing electronic eligibility tools, payer websites, and calls to payers are performed in order to discuss any financial responsibilities with the patient. The financial counselor is responsible for accurate and timely processing to make determination of eligibility for The Guthrie Clinic Charity Care Policy.   Communications with the patients will be held prior to, at time of service or after services have been provided and will result in the collection of patient responsibilities in full, the establishment of a payment plan or applicable financial assistance applications to determine the patient’s ability to pay in accordance with Federal Income Guidelines and Financial Aid Laws.   Guides patients to establish a means of meeting their financial obligations in a manner which protects the financial standing of Guthrie Medical Group, Robert Packer Hospital, Corning Hospital, Troy Community Hospital, Towanda Memorial Hospital and Cortland Medical Center.

Education, License & Cert:

 Associates degree preferred.  High School diploma or equivalent required.

Experience: 

Minimum of 2 years applicable, transferable, work experience required. Background in health care financial services, medical billing and insurance regulations preferred. Must possess a working knowledge of basic health care billing and coding. Excellent organizational and customer service skills a must. Requires excellent listening, verbal and written communication and interpersonal skills.   Aptitude for financial equations, speed in calculation, attention to detail, and ability to multi‐task.

Essential Functions: 

1. Communicates with patients and family members in person and by phone to explain fees for treatment, any applicable insurance coverage, and patient financial responsibility with respect to Guthrie Medical Group patient billing policies, payment arrangements, and eligibility of any external governmental need‐based programs and internal need based programs.

2. Review a pre‐visit report daily to identify prior account balances and contact patients by phone to make payment arrangements.  Efforts will be made to arrange to meet with them prior to or after their visit to resolve balances due.  An indicator message will be placed on the appointment if no financial arrangement was made by phone.

3. Develop a daily accounts receivable report, monitoring and communicating with the front office staff detailing the satisfactory arrangements were or were not met and/or to advise the amount of money to be collected from the patient at time of service.

4. Confirm demographic information, verify eligibility and insurance benefits and coverage limitations to explain to the patient and review all current and estimated financial responsibilities. Determine if patient may be eligible for any internal or external financial assistance programs and counsel and assist patients with completion of appropriate applications for those programs.

5. Responsible for accurate and timely processing of applications in accordance with The Guthrie Clinic Charity Care Policy guidelines and completion of Charity Care worksheet, and uphold strict confidentiality related to patient health information in accordance with HIPPA compliance.

6. Responsible for validating all required financial information received and the completed Charity Care application, and uphold strict confidentiality related to patient health information in accordance with HIPPA compliance.

7. Forwards all completed information for eligible or ineligible applicants to CBO Director for final approval or denial and provide written notification to Charity Care applicants when a decision is reached regarding eligibility.

8. Establish satisfactory payment arrangements for remaining balances after a charity care determination is made based on applicant’s disposable income.

9. Maintain and update, daily, the Charity Care Excel reporting logs used to track all charity activity and ensure all participating Guthrie entities have access to current account information. 10. Promptly reports system issues to Coordinator and/or Manager and provides feedback related to workflow processes to promote efficiency.

Other Duties: 

1. Other duties as assigned.