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FINANCIAL COUNSELOR - (19943)

Universal Health Services


Location:
TUCSON, AZ
Date:
02/20/2018
2018-02-202018-03-21
Job Code:
19943
Universal Health Services
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Job Details

Deltek Talent Management - FINANCIAL COUNSELOR - (19943)

Job Details


FINANCIAL COUNSELOR - (19943)

Facility Name
Palo Verde Behavioral Health
Location
TUCSON, AZ 85712 US (Primary)
Career Area
Support & Entry Level
Category
Billing
Job Description

::

Palo Verde Behavioral Health (PVBH) is a 84 bed  private psychiatric facility providing inpatient and intensive outpatient psychiatric services through treatment programs tailored to our patients needs for the purpose of creating positive outcomes. PVBH will build on the excellent skills of our current Psychiatrists, licensed registered nurses, clinical social workers and licensed professional counselors to support these programs.

 Mission Statement

The mission of Palo Verde Behavioral Health is to provide the highest quality of psychiatric patient care through treatment programs focused on improving the lives of our patients and ensuring their experience during their stay supports their road to recovery.

Vision Statement

Palo Verde Behavioral Health will be recognized as the premier regional provider of innovative, compassionate behavioral health services, which enhance the health of our community. We will exceed the expectations of those served, maintain the highest standards, and promote a rewarding work environment.

JOB DESCRIPTION:  

The Financial Counselor is responsible for verifying benefits and eligibility on admission inquiries, preparing financial folders, collecting co-pays/deductibles from patients and collecting insurance payments, assisting with establishing effective and timely payment plans, coordinating with utilization review and discharge planning efforts limit risk of non-payment, providing ongoing patient benefit information, participating in patient discharge procedures, and coordinating financial arrangements with collecting personnel.

Job Requirements

::

JOB REQUIREMENTS:

Education: High school graduate or equivalent preferred.

Experience:  A minimum of one (1) years experience in admission processes and collections procedures, and a working knowledge of managed care; interpretation of insurance coverage plans, co-payments and deductible schedules and payment plans; and a working knowledge of computers and business software programs (Excel/Word) preferred.  A minimum of one year experience in data entry.  Must be proficient in 10-key and typing.  

Additional Requirements: May be required to work occasional overtime and flexible hours.

KNOWLEDGE/SKILLS:

  1.   Knowledge of admissions processing/billing processes and procedures.

  2.   Knowledge of insurance coverage, co-payments and deductibles.

  3.   Knowledge of CPT codes and all code procedures.

  4.   Knowledge of computers and business software, including Excel.

  5.   Knowledge of managed care.

  6.   Knowledge of payment planning and billing techniques.

  7.   Skill in organizing and prioritizing workloads to meet deadlines.

  8.   Skill in telephone etiquette and paging procedures.

  9.   Effective oral and written communication skills.

10.   Ability to communicate effectively with patients and co-workers.

11.   Ability to adhere to safety policies and procedures.

12.   Ability to use good judgement and to maintain confidentiality of information.

13.   Ability to work as a team player.

14.   Ability to demonstrate tact, resourcefulness, patience and dedication.

15.   Ability to accept direction and adhere to policies and procedures.

16.   Ability to recognize the importance of adapting to the various patient age groups (adolescent, adult and geriatric).

17.   Ability to work in a fast-paced environment.

18.   Ability to meet corporate deadlines.

19.   Ability to react calmly and effectively in emergency situations.

 

PRIMARY RESPONSIBILITIES:

Upon receipt of an intake inquiry form, verifies eligibility and benefits for all admissions.

Communicate benefits information and co-payments to patients and families prior to admission.

Obtain after-hours admission files from the I& R department each morning if not delivered, with any exceptions approved by the office management.

Maintain ticker filing system for benefit expiration; and communicate on a daily basis with the Business Office Director.

Ensure all pre-admission and admission calls and paperwork are addressed and completed in an accurate manner:

Contact the appropriate agencies to obtain treatment authorization telephone numbers, reimbursement structure, and patient eligibility.

Conduct a financial interview with the patient/ family prior to admission based on insurance verification, calculate the amount of deposit necessary and collect the deposit or makes arrangements for payment.

Verify employment and insurance information.

Complete the telephone profile of insurance benefits in a timely manner.

Review required admission forms to insure they are completed accurately and appropriate signatures are obtained.

Assign the correct financial class and adjust financial class required.

Notify the appropriate facility management of any potential problems related to admission or payment.

Obtain a deposit and explain benefits and financial obligations within 48 hours of admittance.

Complete a demographic pre-certification if required.

Complete the financial folder within one working day of admission, and schedule all critical dates for appropriate follow up;

Provide financial folder to the appropriate facility management for review within one working day of admission.

Ensure written confirmation of benefits and eligibility is sent to the primary and secondary insurance carrier, and scheduled for follow up.

Provide financial counseling to patient and/or guardian or assigned responsible party:

Contact patient or assigned contact within 48 hours to make payment arrangements and to obtain deposits if not done prior to admission, with all exceptions approved by Business Office Director.

Serve as patient liaison between family or assigned parties, and business office staff.

Obtain financial worksheet and income proof, as required, prior to discharge.

Complete timely and effective payment arrangements prior to or upon discharge whenever possible.

Participate in completing appropriate paperwork for patient discharge, and coordinate patient financial arrangements.

Maintain all in-house accounts in a current and accurate manner;

Review all in-house accounts and clearly documents the status of the file regarding all financial and legal issues. Complete all required information.

Clearly document all activity occurring during the admission as it pertains to eligibility, benefits, reimbursement and required signatures.

Coordinate with other departments within the facility to assure appropriate usage of patient benefits:

Coordinate with the case management staff to determine benefits for reduced level of care.

Coordinate with case management staff and physicians / licensed practitioners for treatment extensions when appropriate, as well as coordinating coverage limits and other length of stay issues for patients.

Provide back-up support to the receptionist/ switchboard as required.

Adhere to facility, department, corporate, personnel and standard policies and procedures.

Attend all mandatory facility in-services and staff development activities as needed.

Adhere to facility standards concerning conduct, dress, attendance, and punctuality.

Support facility-wide quality/performance improvement goals and objectives.

Maintain confidentiality of facility employees and patient information.

Note:  The essential job functions of this position are not limited to the duties listed above.

 

PHYSICAL, MENTAL, AND SPECIAL DEMANDS

THIS SECTION DESCRIBES HOW AN EMPLOYEE IN THIS POSITION CURRENTLY PERFORMS THE FUNCTIONS OF THIS POSITION.  MODIFICATIONS TO THE MANNER IN WHICH THIS JOB MAY BE PERFORMED WILL BE REVIEWED ON A CASE BY CASE BASIS.

 1.    Ability to work a 40 hour week.

 2.    Ability to sit for long periods, up to 8 hours.

 3.    Ability to use both hands in fine manipulation of small tools (copier, computer, telephone, typewriter, calculator, safe, facsimile machine).

  4.   Ability to push and pull up to 10 lbs. (file cabinet drawers, computer payer boxes).

  5.   Ability to see well enough to read handwritten and typewritten material.

  6.   Ability to lift and carry up to 25 pounds to move transfer file boxes, data processing paper and newly admitted patients’ belongings, as required.

  7.   Ability to frequently reach, turn, and twist above and below the waist daily to retrieve files from top shelves to get office supplies from upper shelves in supply closet.

 8.    Ability to retrieve files from bottom shelves and drawers and to move boxes of paper and forms to computer printer.

 9.    Ability to spend 90% working time in an environment of continuous low voices and office machine noise typical for business office atmosphere.

10.   Ability to handle a variety of repetitive tasks.

 

MACHINES, TOOLS, EQUIPMENT, AND OTHER WORK AIDES:

THIS SECTION DESCRIBES THOSE MACHINES, TOOLS, EQUIPMENT AND OTHER WORK AIDE AN EMPLOYEE IN THIS POSITION MUST BE ABLE TO USE.

 1.    Telephone, switchboard and paging system.

 2.    Copy machine.

 3.    Computer and various software packages.

 4.    Calculator/10-Key.

 5.    Facsimile machine.

 6.    Postage meter.

 7.    Typewriter.

 8.    Policies, procedures, plans, and program manuals.

 

SERVICE EXCELLENCE CRITERIA:

Treats everyone as a guest.

Makes a positive first impression and continues that positive impression through ongoing efforts
Anticipates the needs and expectations of all people encountered
Displays service recovery skills; is responsible for resolving dissatisfaction without assigning blame

Demonstrates professionalism and excellence in all things.

Demonstrates professionalism in look, what to do, and what to say

Holds self accountable – Is a positive role model

Delivers excellence that goes beyond departmental and individual job responsibility

Practices teamwork

Participates in decision-making and process improvement, regardless of level in the organization

Communicates effectively within and beyond assigned team

Focuses on the problem or issue, not the person

Behaviors:  Always says “please” and “thank you”.  Makes a good first impression by projecting a positive attitude; greets patients, guests and staff warmly.

Behaviors:  Always wears name badge.  Demonstrates a professional image through manner of dress, respectful communication, and adherence to hospital badge policy.

Behaviors: Holds self accountable for getting the information needed to know to do job.  Responds to client and customer questions, concerns and grievances in a timely manner, informing complainant of process and expected time of resolution.

Behaviors:  Uses language appropriate to the situation and to the guest.  Is a team player, showing respect for peers, supervisors, patients and guests, demonstrated through verbal communications and commitment to the work group.

Behaviors:  Greet guests with eye contact and a smile.  Staff is timely when responding to patient needs and requests by making eye contact and verbal contact when patient presents self at nurse’s station or any other area where staff is located.

Behaviors:  Always end an interaction with the guest by asking, “Is there anything else I can do for you?”  Provides service to patients and families that is prompt, caring, efficient and effective.

Demonstrates respect for the hospital environment by keeping work areas organized and clean, and taking pride in the facility as a whole. 

 

GENERAL CRITERIA

Attendance:  Consistently reports to work on time and is ready to work at start of shift.  Appropriately utilizes personal days/sick time.  Clocks in/out per policy and procedure; begins/returns from meal periods and rest breaks within established policy time frame.

General Safety:  Follows all departmental and hospital safety, security and infection control policies.

Self-Development:  Maintains required licensure/certification for position; renews by expiration date; CPI training; renews by expiration date.  Gains additional formal qualifications beyond the minimum requirements of the job; as well as additional job duties and skills.  Follows up on any personal development plan.  Maintains current knowledge of policies and procedures, protocols, and practices.  Attends inservice programs.

Professional Appearance and Attitude:  Complies with the Personal Appearance policy.  Consistently demonstrates a self-directed, mature and disciplined approach to completing work duties.  Demonstrates emotional capacity to perform within position responsibilities.  Maintains and respects patient and employee confidentiality.  Follows proper lines of authority and organizational structure.

 

The Following is the minimum knowledge, skills and behaviors necessary to provide care and service for the patient population served:

AGE GROUP ENCOUNTERED:            Adolescent – (13-17 yr. old)           

                                                           Adult – (18 - 54 yr. old)      Geriatric – (55 or above)

Must be able to demonstrate knowledge of patient rights, advanced directives and ethical issues for all age specific groups.

Must be able to demonstrate the skills and knowledge to provide appropriate interventions based on the needs of various age groups.

Must be able to demonstrate knowledge and ability to advocate, communicate and educate patients of all age groups served, including those with physical, emotional, social, mental, language and cognitive impairments.

Must be able to demonstrate knowledge and ability to collaborate with medical staff, other health professionals to achieve desired outcomes for age specific groups served.

 

The Following is the minimum knowledge, skills and behaviors necessary to provide care and service for the patient population served (Continued):

Must be able to demonstrate knowledge and skills to interpret age related data and appropriately consulting with other team members and/or planning care based on those results.

Must be able to demonstrate ability to involve patients/family/guardian/care taker in decision making related to care and treatment appropriate for various ages served.

Must be able to demonstrate ability to provide patient/family education, explaining care, treatments, discharges instruction etc. using correct terminology and technique to address educational needs of each age group served.

Must be able to demonstrate knowledge and ability to assess and provide appropriate interventions in the event of abnormal family dynamics for various age groups including; child abuse, domestic violence, and elder abuse.

Must be able to demonstrate knowledge and ability to provide a safe environment of care and recognize safety risks/considerations of each age group served.

Must be able to demonstrate proper application and knowledge of policies and procedures related to restraint alternatives and usage for various ages of patients served.

Must be able to demonstrate knowledge of the principles of growth & development of the life-span.

Must be able to modify and deliver care that is specific to the age and growth & development of the patient served.

Must be able to demonstrate knowledge and ability to provide structured educational groups.

 

 

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