Sr. Financial Counselor | Patient Eligibility

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

The Sr. Financial Counselor will support the team by serving as a subject matter expert, responding to team member inquiries while being a resource for routine administrative tasks for department leadership. This role will help monitor patient accounts for accuracy and follow through of work assigned to the team while assisting with escalations from team members.

Responsibilities and Duties:

• Determine patient responsibility and eligibility through Insurance, Federal, State, and/or County government benefits. Review accounts for proper plan codes, financial class, and patient type.

• Contact appropriate agencies to verify assumptions of liability.

• Negotiate flat rates on accounts where the patient has no linkage to government programs.

• Meet with patients at bedside to inform them of financial responsibility prior to discharge.

• Set up payment plans with patients prior to discharge and document payment arrangements in patient accounting systems. Provide mailing envelopes and payment dates to patient before discharge.

• Collect monies from patients when there is an estimated patient liability due on the account.

• Monitor Medicare days and co-insurance days on in-house patients. Review all in-house Medicare accounts on the 1st and 15th of each month. Update account with Eligibility info in detail.

• Document all payer and patient financial information in the hospital computer system.

• Retrieve Inpatient Census patient information within the facility to follow up on In House patients not insured or under insured.

• Obtain complete and accurate patient information including possible insurance(s), and financial information by communicating with patients, family members, and physicians regarding their stay.

Coordination Assistance:

• Serve as a backup in coordinating with Financial Counselors and supervisors to address escalated issues in the absence of more experienced coordinators.

• Provide support by gathering information, preparing basic reports, and following up on pending account items.

• Assist in coaching and training new/existing Financial Counselors on routine account procedures and workflows under the guidance of department leadership.

• Communicate daily with co-workers, hospital and management regarding account progress and/or other issues.

• Utilize organization and prioritization skills in daily tasks to ensure completion of daily processes.

• Maintain open and positive professional communication orally and written at all times.

Program Identification and Application Submissions:

• Manage the identification, submission, and re-submission of basic claims to ensure adherence to proper application guidelines.  

• Assist in identifying applications, billing discrepancies, and communicating findings to management for resolution.

• Monitor low-complexity account trends and provide input on potential process improvements.

• Ensure compliance with all applicable regulations, policies, and procedures.

Operational Support:

• Provide general support for departmental initiatives and projects.

• Participate in team meetings and provide input on standardizing operational practices.

• Represent department on weekly calls with clinical staff to provide updates on eligible patient programs and status.

• Create reports, workflows, and job aids

What You Will Need:

• High School Diploma or equivalent (relevant experience may be substituted for formal education)

• 3-5 years of experience in Patient Eligibility and/or Financial Counseling

• Strong knowledge in Healthquest, Advocatia, and Powercharts

• Understanding of Financial Counseling process, including POS (point of service) collections

• Extensive knowledge of Patient Eligibility program qualifications for Social Security, Medicaid, and VOVC

• Strong verbal and written communication skills

What Would Be Nice to Have:

• Knowledge of the financial assistance program

• Knowledge of Medicaid Application process

• Understanding of Medical Records request process

• Knowledge of SSI appeals and reapplication process

• Ability to multitask and meet deadlines

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What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.