Financial Counselor

Financial Counselor

Position Highlights

• Position: Financial Counselor
• Location: Evanston, IL
• Full Time
• Hours: Monday-Friday, 8:30am – 5:30pm
• Rotating Weekends

Job Summary

Reporting to the Manager of PFS, the Financial Counselor works with patients and/or their representatives to resolve patient account issues, develop payments plans and secure payments. Effectively screens patients for compliance with payer requirements and corrects and updates accounts to bill appropriate parties. Ensures patient information needs are met, and that they understand the hospital’s revenue cycle expectations including resolution of personal liabilities through various payment options. Assists customers with the financial assistance application process. Researches historical cases in the hospital’s utilization software system to develop cost estimates for out- patient and inpatient services.

What you will do

• Communicates with patients and their representatives, physicians and their office staff, employers, and ancillary departments to accurately collect and review all required demographic, insurance/financial, and clinical data necessary to expedite payment on patient accounts. May consult with patients and patient family members in patient’s room to gather and research required insurance and benefit information. Electronically records gathered information in hospital systems and logs.
• Receives and reviews all inpatient admission and outpatient services self-pay accounts received from ancillary departments/physicians to determine if a significant deductible or payment is applicable. Interviews and consults with potential customer walk-in/ telephone inquiries and physicians requesting written estimates for inpatient or outpatient services. Collaborates with internal departments and physicians’ offices to collect information required to develop price estimates including ICD-9 or CPT codes, location of service, inpatient/outpatient status, duration of service, special medical supplies and equipment, anesthesia type, physician preferences, etc.
• Conducts research in the hospital’s utilization software system searching for comparable historical cases to determine self-pay account liability and to construct written estimates for potential customers and physicians considering NCH for services. Enters variable case elements in the utilization system entering specific demographic and service parameters to drill down and target appropriate case cost comparisons. Consults with Decision Support department resources on requests for complex estimates or when limited utilization data exists. Prepares written estimates for customers and physician’s offices based on information provided.
• Obtains required financial information from patients including identification of payment sources and reviews financial assistance options. Assists patients with completion of financial assistance applications including a review of bank and financial statements, tax returns, pensions, retirement and stock funds; requests additional information, approves or denies applications, performs write-off within department policy.
• Negotiates and secures initial co-payments. Communicates hospital policies and establishes payment arrangements with patients per hospital and financial assistance policies and procedures. Follows the Health Insurance Portability and Accountability Act (HIPAA), payer and applicable regulations and standards for registration and billing. Verifies patient financials are complete by ensuring benefits have been approved and received, and that co-pays and deductibles are paid. Formulates an agreed upon payment plan prior to outpatient services or inpatients being discharged from the hospital.
• Collaborates with NCH patient financial services and medical records staff, physician’s offices and insurance carriers to research and adjudicate outstanding patient account balances and refunds. Conducts follow-up telephone calls to patients /guarantors regarding outstanding self-pay account balances. Explains account balances, payment policies and secures payment arrangements within hospital collection policies or financial assistance options. Sends follow-up letters to patients regarding status of account and issue resolution and generates mailings for all accounts that do not have a completed Medicare Secondary Payer questionnaire for hospital adherence to Center for Medicare & Medicaid Services (CMS) guidelines.
• Maintains work queues, performs necessary tasks to complete the account which may include, use of activity codes, notification and follow-up with patient via phone or written correspondence, follow-up with 3rd party payers, research within Patient ID and/or credit rating software to manage NCH accounts receivables and meet timely filing or other payer and contractual requirements.

What you will need

• High School graduate or equivalent
• Bachelor’s degree preferred
• 5 years’ experience in patient care setting with knowledge of billing and insurance preferred and progressive work experience in hospital revenue cycle, patient access, insurance verification, financial counseling, billing, collections, or financial assistance is preferred
• Experience/knowledge relating to State and Federal funded programs
• Demonstrated expertise in patient insurance and billing
• Computer knowledge to include Microsoft Word, Excel, Outlook, Access, Power Point
• Excellent interpersonal and communication skills, telephone etiquette, guest relations focus and exceptional organizational skills
• Proficiency and understanding of the Financial Assistance Policy and Billing and Collections Policy
• Understanding of patient accounting practices in a healthcare setting
• Ability to assess personal financial documents and identify sources of income including bank statements, paystubs, checks, and tax documents
• Familiarity with billing and collection processes including insurance claims, patient responsibility, and payment methods
• General knowledge of healthcare terminology (e.g. procedures, diagnoses, CPT/DRG codes)

Benefits (For full time or part time positions)

• Premium pay for eligible employees
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals – Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) – all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org .

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website ( www.endeavorhealth.org ) to better understand how Endeavor Health delivers on its mission to “help everyone in our communities be their best”.

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

At Endeavor Health, we are united by a shared commitment to working together to create a culture of connection and belonging—each of us bringing different skills and experiences as we deliver safe, seamless, and personal care. Every person, every time. We are committed to fostering an environment where all team members can be their best, learn, and pursue excellence together.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.