The financial counselor promotes awareness of the healthcare marketplace exchange and expanded New Jersey Medicaid. The position assists with enrollment of eligible consumers into a health plan. The financial counselor is responsible for understanding the initial patient registration process, conducting billing inquiries, making payment arrangements, maintaining patient financial records and collecting co-payments and deductibles. The financial counselor communicates and collaborates with federally qualified health center (FQHC) team members, AIT and Finance in a timely manner. The financial counselor will be knowledgeable of state and federal government funding programs, such as Medicare, Medicaid, TRICARE/CHAMPUS and worker's compensation, and commercial insurance payers; billing and reimbursement guidelines and methodologies for state and federal government and non-government payers; insurance terminology; medical terminology; HIPAA privacy; and compliance practices. The Financial Counselor is responsible for NJ Uncompensated Care, also known as Letter of Agreement (LOA). This position is responsible for training staff on financial eligibility programs. The financial counselor conducts monthly audit with AIT and Finance to provide LOA data.
The counselor must attend all Medicaid Presumptive Eligibility (PE) trainings and have an 80% passing score to obtain a PE User ID.
The counselor demonstrates knowledge of financial liability and financial assistance procedures. The financial counselor is considered a customer service champion responsible for delivering great customer service at each entry point throughout the health system. The financial counselor is responsible for patient throughput, completing financial clearance on all scheduled appointments at the FQHC. The financial counselor must be able to independently perform insurance management and internal LOA audits. Attends all recommended department meetings and in-services.
This position supports FQHC goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to teamwork and cooperation.
EDUCATION: High school diploma or equivalent is required. Ability to read, speak and write in English required.
LICENSE/CERTIFICATION: Attendance of all mandated federal facilitated market base training required. Application for counselor certification required within 1 year from date of hire or transfer.
EXPERIENCE: Minimum 3 years of medical/billing insurance experience required. Strong communication, math, interpersonal and organizational skills required. Ability to problem solve and work independently with little supervision. Bilingual ability in Spanish preferred.
Demonstrates the competencies as established on the Assessment and Evaluation Tool for this position.
This position requires reaching, stooping, kneeling and crouching approximately 25% of the workday. This position also requires frequently lifting, approximately 25-30 pounds, and occasional lifting of 50-100 pounds with assistance.
The essential functions for this position are listed on the Assessment and Evaluation Tool.
This position reports to FQHC leadership team.
The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.
AtlantiCare is an equal opportunity employer that takes affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability.