Financial Coordinator III

POSITION SUMMARY:

The Financial Counselor assesses all aspects of patient financial account management for nursing home stays. The Financial Counselor is accountable for coordinating all activities necessary to financially secure the resident’s account through the verification process; resolving complex problems that include but are not limited to: ensuring applicable insurance coverage; ensuring continued coverage for length of stay; Cobra entitlement; Medicare SNF covered days; and Long term care issues. Involves in-depth communication; collaboration; and follow-up with patients; families; third-party payers; governmental agencies; employers; social work; financial case management; and utilization management. The Financial Counselor is ultimately responsible for capturing accurate insurance information to minimize revenue delays.

This role may have the option to work a hybrid-remote schedule and communicate daily through virtual meetings.

SUPERVISION AND DIRECTION EXERCISED :

Responsible for monitoring own performance on assigned tasks. Self-directed and must make complex decisions independently. May train other support staff.

MACHINES AND EQUIPMENT USED :

Standard office equipment, including but not limited to telephone, page system, mail meter, personal computer, printer, photo copier, fax, RightFax, OnBase, EPIC, Point-Click-Care, and third party verification systems.

TYPICAL DUTIES :

Customer Interactions - Essential 15 %:

Creates a professional and effective customer oriented environment by utilizing excellent communication skills to review demographic information; confirms insurance information; discusses financial obligation; contacts Billing Specialist to request any necessary updates to demographic and insurance information.

Financial Management – Essential 70 %:

• Reviews notice of admission and referrals for appropriate insurance coverage by utilizing the nursing home system along with all third party payer systems.

• Identifies and confirms self-pay patients and/or need for assistance with co-pays and deductibles for appropriate referral to Financial Case Management for possible Medicaid application.

• Completes LDSS-3559 for each individual event i.e. Admission; change in status; discharge and forwards to appropriate Local Department of Social Services; NYS exchange and/or Medicaid Managed Care Plan/Medicaid Long Term Care Plan.

• Performs Roster Reconciliation to ensure NAMI information is correct for current residents and report to Billing Specialist if DSS files reflect incorrect information regarding patient census.

• Informs patients or their designated representative(s) of any exhaustion of benefits, including obtaining signed Notice of Medicare Non-Coverage (NOMN) forms, if applicable. In the event of disability, vacation, or vacancy, this duty will return to Social Work.

• Notifies and monitors patient’s COBRA entitlement and assists with paperwork if necessary.

• Determines the primary payer through knowledge of Medicare and other payer regulations for the coordination of benefits.

• Notifies Utilization Management of clinical requests by third party payers.

• Maintains a monitoring system for adequate benefit coverage and eligibility throughout the Resident’s stay.

• Accountable for meeting nursing home standards to meet facility, state, local and federal regulations.

Quality- Essential 15 %:

• Manage Census Activity (admissions, discharges, payer source changes)

• Consistently monitors resident’s insurance coverage to ensure eligibility.

• Knowledge of Medicare’s nursing home guidelines and limited coverage.

• Attends the Current house meeting, monitors the current house report for any level of care changes, and ensures there is appropriate coverage.

• Reviews Medicare for MSP questions and validation.

• Attends educational programs regarding compliance at the Manager's direction.

• May train or perform other duties assigned by management.

• Reviews roster for Medicaid recertification.

QUALIFICATIONS :

AAS in related discipline (admitting/registration/patient billing/insurance) with 3 years of related experience, preferably in a nursing home setting, or an equivalent combination of education and experience. Requires a high degree of professionalism and motivation with excellent written and verbal communication and customer service skills; ability to work independently as well as in a team environment; highly collaborative; self-starter; strong computer skills and ability to type 45 words per minute. Strong knowledge of Medicare, Medicaid and HMO processes. High comfort level to meet with residents/families. Flexible to work weekends, other assigned hours and/or responsibilities as needed.

NOTE : This document describes typical duties and responsibilities and is not intended to limit management from assigning other work as required.

The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University’s mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

Pay Range

Pay Range: $19.37 - $27.12 Hourly

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

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Location: Strong Memorial Hospital
Full/Part Time: Full-Time
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