Financial Resolution Advocate

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The Financial Counselor-Cashier interprets and applies financial policies to make appropriate financial decisions and payment arrangements to ensure financial viability. Prepares and presents fee estimates to current and potential patients. Provides financial education regarding benefits to patient to assist in understanding their personal financial liability. Demonstrates the ability to assertively pursue necessary information and to function independently to secure financial resolution on accounts.

This role is also responsible for the timely and accurate posting of patient payments and adjustments to the patient accounts. Also responsible for daily cash and adjustment reconciliation with the patient account system and the accounting department for payments made at the hospital.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school graduate or equivalent.

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1. Two (2) years’ experience in a healthcare setting.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Interviews patients who are referred for financial counseling in person or via the telephone to determine financial counseling needs and to help formulate a plan for financial resolution.

2. Uses CPT codes to calculate the estimated procedure cost.

3. Based on information provided by the patient, an initial determination will be made if the patient has adequate benefits or qualifies for Medicaid, special programs or payment arrangements based on federal, state and hospital policy.

4. Educates patient on their benefits, patient liability and/or the process for applying for Medicaid, completion of the financial statement and payment alternatives.

5. Informs patients of hospital and clinic billing practices/policies and their rights and responsibilities regarding payments.

6. Insured patients who are responsible for a balance after insurance will receive a preliminary financial overview and will be assisted in completion of the financial statement if necessary for financial resolution.

7. Reviews completed financial statements and makes a determination based on hospital policy if the patient qualifies for a payment arrangement and documents in the registration/billing systems.

8. Works with specialty departments to establish appropriate financial arrangements for elective services.

9. Identifies and accurately resolves potential patient account issues for WVUH and UHA billing departments.

10. Resolves billing questions for patients who present to the Inpatient, Chestnut Ridge or Physician Office Center patient services area.

11. Monitors daily reports to identify large dollar account balances and private pay patients that need resolution.

12. Refers patients to local, state and/or federal agencies for assistance.

13. Obtains demographic/billing/insurance information from patient/family/legal guardian and enters into the registration/billing systems for service and claim processing. Obtains and scan patient’s insurance/medical cards and driver’s license into the registration system.

14. Collects deposits/co-payments/deductibles/patient liability payments when applicable, provides patient receipt and documents payment in the registration/billing systems.

15. Balances daily receipts and cash drawer for patient payments, prepares and delivers deposit bag to cashier’s office.

16. Follows up on accounts as indicated by system flags (courtesy dismissal/comments/red stickers).

17. Maintains registration accuracy threshold of 98% as identified in audit processing.

18. Initiates auto accident liability coverage. Identifies all patients involved in an auto accident and obtains all pertinent information regarding medical or non-fault liability and documents in registration/billing systems.

19. Initiates ERSD (end stage renal disease) screening. Identifies ESRD patients and obtains all pertinent information regarding coverage by SSI and documents in the registration/billing systems.

20. Initiates Veterans Administration eligibility screening. Identifies all VA eligible patients and coordinated admission/treatment with AV and documents in the registration/billing systems.

21. Initiates Black Lung SSI screening. Identifies all patients covered under Black Lung and documents in the registration/billing systems.

22. Initiates Workers Compensation screening. Accurately identifies all patients seeking treatment for work related injuries. Assists in completion of appropriate paperwork and documents in the registration/billing systems.

23. Initiates MSP (Medicare secondary screening). Obtains all information regarding MSP. Documents in registration/billing system all information required on the MSP form.

24. Maintains timely and accurate posting according to departmental goals and report to management.

25. Documents accounts clearly and accurately.

26. Collects patient copays and deposits according to insurance coverage regulations and our organizational financial policy.

27. Communicates account information to patients.

28. Maintains petty cash transactions and request monthly reimbursement funds.

29. Completes and reconciles bank deposits daily.

30. Reviews and reconciles all postings monthly with the accounting department.

31. Exercises proper stewardship through the appropriate use of supplies, equipment and time.

32. Communicates and interacts with clients, families, visitors, physicians, departmental and hospital staff and the public in general in a manner that demonstrates professionalism and concern for the individuals' need(s).

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping and feeling are necessary body movements utilized in performing duties throughout the work shift.

2. Must be able to sit for extended periods of time.

3. Visual acuity must be within normal range.

4. Must be able to exert in excess of 50 pounds of force occasionally to move patients or objects.

5. Must have manual dexterity to operate keyboards, fax machines, telephones and other business equipment.

6. Must meet Department of Labor’s MEDIUM duty standard (MEDIUM WORK- exerting up to 50 pounds of force occasionally, and/or up to 20 pounds of force frequently, and/or up to 10 pounds of force constantly).

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Office type environment.

2. Patient care environment.

3. May be required to travel between facilities/buildings.

SKILLS & ABILITIES:

1. Ability to accurately utilize applicable computer software and equipment for access processing.

2. Must have reading and comprehension ability.

3. Basic knowledge of medical terminology.

4. Basic knowledge of time of service collection procedures preferred.

5. Basic knowledge of ICD-9 and CPT coding preferred.

6. Ability to type 25 words per minute.

7. Projects a mature problem-solving attitude while dealing with interpersonal conflict, dissatisfied patients and time demands

8. Maintains knowledge of revenue cycle operations, third party reimbursement, local/state/federal regulations and medical terminology.

9. Knowledge will include at minimum, all aspect of payer relations, claims adjudication, contractual claims processing and general reimbursement procedures.

10. Uses excellent customer service, written and oral communication skills.

11. May have unsupervised access to patient confidential information.

12. Knowledge of posting software preferred.

13. Maintains knowledge of current online banking systems.

14. Maintains knowledge of current discount contract agreements.

15. Strong business math and analytical skills required.

16. Comprehensive knowledge of healthcare insurance remittance voucher formats required.

17. Comprehensive knowledge of healthcare insurance remittance voucher coding required.

Additional Job Description:

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

SYSTEM West Virginia University Health System

Cost Center:

535 SYSTEM Centralized Clearance Center

Address:

100 Hoylman DriveGassawayWest Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.