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Job Title: Financial Case Manager - Senior SUMMARY:The Financial Case Manager - Senior is responsible for reviewing uninsured and under-insured patient accounts by following the insurance verification process.Community/Acute - The FCM - Senior will assist under-insured patients by screening for secondary coverage options, applying for financial assistance and other government based programs. This person assists patients with setting up interest free payment plans and work closely with Patient Financial Services to help resolve coordination of benefits (COB) issues.Long Term Care – The FCM - Senior will assist residents in applying for and recertifying in Medicaid coverage. This entails interviewing and screening resident and family for financial history, investigating and obtaining financial documentation needed from but not limited to banking institutions, financial markets including life insurance agencies, pension programs, and investment firms. This person will work closely with system and outside attorney agencies as well as the Department of Social Services.All communication must be conducted in a manner that will result in positive patient relations and prompt reimbursement for services rendered. The FCM may also help in internal continuous improvement initiatives around financial performance. This individual works collaboratively with multiple departments of our organization.

RESPONSIBILITIES:

+ Assesses the healthcare coverage needs of uninsured and under-insured patients.

+ Verifies insurance coverage to identify uninsured patients who may be eligible for insurance enrollment, and provides the FCM II accurate information for patient interview when needed.

+ Assists under-insured patients with applying for secondary coverage, in acute setting financial assistance applications and other programs in which they be eligible.

+ Complete all financial and secondary insurance applications with high quality work, gathers all necessary documentation and submit them to the proper agency / staff for processing.

+ Notifies the appropriate staff of pertinent information and enters notes into both the financial and clinical sections of the electronic health record in a timely manner.

+ Establishes payment plan arrangements for patients per policy for hospital and clinical accounts.

REQUIRED QUALIFICATIONS:

+ Associates Degree in related field with four years of experience preferred or an equivalent combination of work experience in financial counseling, long term care setting, healthcare billing or customer/patient service is required.

+ Three or more years of Medicaid enrollment experience required

PREFERRED QUALIFICATIONS:

+ Base knowledge of health care governmental assistance programs, guidelines, and application procedures.

+ Able to communicate and respond to inquiries; requires effective interpersonal skills and ability to interact with the patients to explain payment policies and persuade patients to settle account balances.

+ Ability to manage multiple concurrent assignments in a fast-paced environment.

+ Ability to utilize Care Connect system effectively and accurately upon initial completed training.

+ Skilled establishing priorities to complete work in a timely manner despite changes in workload, deadlines, or competing requirements.

+ Demonstrate strong interpersonal and organizational skills to interact courteously and effectively with physicians, patients, and staff members.

+ Ability to interact with all members of the organization in ways that enhance understanding, respect, cooperation and problem solving.

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:

S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$24.75 - $27.50

CITY:

Rochester

POSTAL CODE:

14617

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.