Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.
Job Role Summary
The Financial Counselor assists customers with information necessary for securing verifications from various companies/agencies (Work One, banks, life insurance companies, health information, physician offices, Social Security Administration, Health Department, etc.).
Essential Functions and Responsibilities
Accept daily assigned customer referrals in management designated systems to determine customers to be screened/interviewed
Assist walk-in customers as they present
Explain available payer programs and benefits to customers, including Healthy Indiana Plan, various Medicaid or State programs and services, Health Insurance Marketplace, COBRA, or any other possible third party payer sources, or the hospital's charity program, Health Advantage
Interview/screen customers for all potential payer programs as described in previous job function
Assist customer with information necessary for securing verifications from various companies/agencies (Work One, banks, life insurance companies, health information, physician offices, Social Security Administration, Health Department etc.)
Complete timely submission of documentation and application in management designated system(s), adhering to all deadlines and requesting extensions from management when necessary
Document and update application status in management designated system(s) on a regular basis
Maintain confidentiality of patient health information in compliance with HIPAA regulations
Contact patients by phone, correspondence, or home visit to continue to secure necessary documentation
Monitor progress of applications to ensure application completion and processing timelines are adhered to
Attend interviews (phone or in-person) with State, County or other payer program representatives for those patients with signed authorization that are determined not able to participate, have requested representation, or have a history of lack of cooperation
Update management designated system(s) with eligibility determinations and update all appropriate STAR accounts if eligibility is retroactive
Estimates patient's financial responsibility for services currently rendered (patient's currently admitted as Inpatient or Observation) and secures payment or payment commitment as deemed appropriate by Management
Mentor peers, including training as needed
Ability to meet all productivity and quality requirements
Associate or Bachelor's degree; ORequivalent work/business experience in a healthcare or public assistance setting required.High school diploma required.
Extensive knowledge of eligibility policy rules and processing requirements for programs administered by CMS, FSSA, and other applicable State and Federal programs
Extensive knowledge of health care related insurance rules and guidelines, coverage and benefit plans, and strong ability to calculate and demonstrate insurance and patient payment methodologies and respective amounts due
Strong investigative, analysis and judgment skills
Excellent spelling and grammar; good phone skills; basic math skills; organized, set priorities, meets deadlines; ability to multi-task and carefully proof own work
Must demonstrate effective communication skills by conveying necessary information accurately, listening effectively and asking questions when clarification is needed
Ability to work independently and as part of a team
Professional demeanor in person, email, and over the phone
Proficiency in Microsoft Office Tools
Must be sensitive to the medical needs of customers and professional duties of hospital staff
Ability to adjust to changes in policies, procedures, and systems
Must meet all federal and state required navigator training and certification requirements
Accredited by The Joint Commission and named one of the nation's 150 best places to work by Becker's Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America's best midsize employers' Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care - Center of Excellence in Women's Health, just to name a few.