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SUMMARY

The Financial Case Manager is responsible for reviewing uninsured and under-insured patient accounts by following the insurance verification process.

STATUS: Full Time

1455 East Ridge Road

DEPARTMENT: Financial Counseling

SCHEDULE: Days, Monday-Friday, 8a-4:30p

ATTRIBUTES

• For Community/Hospital setting: Completion of the Certified Application Counselor (CAC) training within 6 months of employment. • 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. • Writing and editing skills to prepare grammatically routine business correspondence; such as email and letters. • Skilled in operating a PC and PC-based software applications, including Microsoft Office. • Ability to solve problems with minimal direction in a stressful environment and maintain a positive attitude. • Demonstrate excellent time management, organizational, verbal, and written skills. • Ability to handle difficult situations involving patients, physicians, or others in a professional manner. • Ability to maintain confidentiality of all medical, financial, and legal information. • May need to travel throughout service area.

RESPONSIBILITIES

Financial Counseling • 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, financial assistance applications in the acute care setting 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 in a timely manner into the financial and clinical sections of Care Connect as well as any additional software programs that may be deemed necessary for the arena working in. • Establishes payment plan arrangements for patients per policy for hospital and clinical accounts. • Thorough knowledge of long term care Medicaid program including necessary forms, documentation requirements, agency regulations and budgeting procedures for Long Term Care arena. • Follows documentation and productivity standards according to policies and procedures. • Assists patients with resolving non-complex coordination of benefit issues. May need to contact third party insurance providers to rectify primary and secondary coverage errors. • Collaborate with Patient Financial Services staff by contacting patients requesting they complete appeal documentation for the acute based hospital accounts. • Track Private Pay residents in Long Term Care setting in order to begin Medicaid application at opportune time as to ensure no gap in coverage for nursing home. • Scanning and saving applications and decisions into system for future reference • Additional duties as assigned with a positive attitude. Customer Service • Conveys courtesy, dignity, respect, and a positive attitude with all individuals. • Demonstrates kindness and empathy when interacting with patients, family and visitors and is able to anticipate the needs of the people we serve. • Collaborates with patients, their family/support person(s), State or County staff, and/or other agencies to ensure patients receive the coverage they are eligible for in a timely manner. Quality • Ensure timely completion of release of information forms, patient financial information, financial obligations, and other applicable Rochester Regional Health forms per policy. • Verifies guarantor and resident information for accuracy. • Updates hospital and clinic accounts accurately with plan code and insurance information. • Ensure all accounts documented timely with accurate and complete information. • Maintains accurate spreadsheets and databases per department standards. • Completes organizational and state (NYS of Health) required training programs. • Ensures compliance with privacy and security standards per Rochester Regional Health policies and procedures.

EDUCATION:

LICENSES / CERTIFICATIONS:

NYS DL - valid New York State Driver's License - New York State Department of Motor Vehicles (NYSDMV)New York State Department of Motor Vehicles (NYSDMV)New York State Department of Motor Vehicles (NYSDMV)

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:

$21.00 - $24.50

CITY:

Rochester

POSTAL CODE:

14621

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.