• AHD Financial Counselor

    Alameda Health System (Alameda, CA)


    AHD Financial Counselor

    + Alameda, CA

    + Finance

    + AH Enrollment

    + Full Time - Day

    + Test Salary Range

    + Req #:41963-31090

    + FTE:1

    + Posted:May 14, 2025

    Summary

    **SUMMARY:** Under general supervision, the AHD Financial Counselor performs a variety of hospital admitting, discharge, registration and financial screening functions, with the objective of determining eligibility for medical coverage under the terms of various private and public health care and financial services assistance programs. This may include programs such as Medicare, Medi-Cal, Breast and Cervical Cancer diagnostic and treatment programs, Managed Care plans, Medi-Cal Managed Care programs, private insurance and numerous other health plans and programs. Performs related duties as required.

    **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE: The following are the duties performed by employees in

     

    this classification. However, employees may perform other related duties at an equivalent level. Not all duties

     

    listed are necessarily performed by each individual in the classification.

     

    1. Advises patient/guarantor of financial obligations; collects and processes deposits, co=payments and pre-payment for services.

    2. Assists patients in resolving issues with billing and collection of their hospital account(s). Reviews and analyzes patient account information, payment history, verifications and collection of insurance or other coverage information and/or assists patient in submitting needed information to billing or setting up payment arrangements.

    3. Assists with special projects and performs related clerical and administrative duties as required.

    4. Contacts and consults with patient, guarantor, or other representative as well as with various County, State, Federal or other outside agencies regarding patient matters related to eligibility for health care services.

    5. Determines eligibility for a third party payment source according to established policies and procedures including private health plans, Victims of Crimes, Workers' Compensation and lawsuit settlements.

    6. Immediately updates all patient financial information in the hospital/clinic information system and submits all applications and supporting documentation to the appropriate agencies and/or departments within prescribed timelines, to ensure timely and accurate submission of claims needed to maximize reimbursement to the Hospital.

    7. Informs and advises medical providers of patients' financial status and maintains open communication with Physicians and clinical staff to ensure timely notification of any health conditions or diagnosis that could qualify for programs to assist them with their healthcare costs.

    8. Interprets laws and regulations of Federal, State and County programs and advises patient of eligibility requirements, as well as their rights and obligations in receiving financial services from these programs. Assists patients in completing applications and forms when necessary and reviews for accuracy and completion.

    9. Plans, organizes and prioritizes workload and processes information at a speed necessary for successful job performance.

    10. Registers and interviews patients to obtain demographic and financial information necessary for patient identification, billing and collection of accounts.

    11. Reviews and investigates health care coverage and policy limitations to update patient information for long term care, short term treatment and/or programs such as Charity, County Medical Services Program (CMSP), Medi-Cal, Family P.A.C.T., Child Health and Disability Program (CHDP), ADAP, and all other related programs.

    12. Reviews difficult or unusual cases with Supervisor or Lead Worker for clarification and to ensure accuracy in assessing patient financial circumstances and eligibility determinations.

    13. Stays informed of both internal and external programs. Researches, reviews, interprets and follows all relevant policies, procedures, regulations, guidelines and laws and attends mandatory trainings. Works independently with minimal supervision.

    MINIMUM QUALIFICATIONS:

    Education: High School diploma or equivalent.

    PREFERRED:

    Preferred Experience: A minimum of two years in customer service in a medical setting, collection agency or hospital accounting position.

     

    Preferred Experience: Bilingual, where necessary.

     

    Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.