Patient Financial Counselor

Description

PRIMARY PURPOSE: 

Responsible for interviewing, verifying insurance benefits, assisting, and performing non-medical case management for uninsured and underinsured patients in regards to their medical, social, and financial needs. Reviews, evaluates, and coordinates health insurance benefits available through public and private health care coverage programs to ensure payment for scheduled clinic services. Acts as a resource to Health Center staff as needed to assist patients with changing plans or providers.

ESSENTIAL JOB FUNCTIONS: 

• Interviews and counsels underinsured and uninsured patients accessing FoundCare clinic services, and determines financial eligibility for healthcare coverage programs.
• Performs ongoing case management for continuous coverage and program compliance, and coordinates results and information to department leader.
• Responsible for reviewing and interpreting income tax papers, self-employment, and income and asset criteria for patient enrollment into healthcare coverage programs.
• Coordinates scheduling of medical appointment throughout EPIC system for program participants.
• Assists in maintaining financial and social case management files and detail records for families, coordination of member materials, and entering program statistics for grant reporting purposes.
• Evaluates, confirms, and documents third-party payer coverage.
• Completes state CAC training courses and pass certification exam.
• Complies with all continuing education and recertification requirements.
• Provides courteous, professional, and confidential assistance to all consumers seeking health benefits.
• Conducts marketing and outreach within targeted neighborhoods about health insurance options through the Florida State Health Marketplace.
• Facilitates enrollment and provides education on public-funded health care programs (Medicaid, Kidcare), Qualified Health plans (QHPs), and Advanced Premium Tax Credits and Cost Sharing Reductions.
• Follows up with clients to troubleshoot appeals and dispute resolution.
• Participates in trainings and meetings to assure strong expertise in public and private health insurance eligibility, application/ enrollment process, and updates.
• Addresses and resolves complex financial questions and concerns that are diverse.  

Requirements

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES: 

• Ability to work independently.
• Ability to multi-task and stay organized.
• Ability to communicate effectively with others, with or without the use of an interpreter.
• Ability to review, understand and apply concepts presented in training programs, conferences, and/or professional literature.
• Excellent interpersonal, organizational, and communications skills.
• Ability to type 30 words per minute and basic proficiency in computer skills, including proficient use of Outlook, MS Word, and Excel.
• Knowledge of insurance and community programs.
• PC proficiency.
• Clear understanding of the FoundCare program and related agencies.

PHYSICAL REQUIREMENTS:

• Ability to endure short, intermittent, and/or long periods of sitting and/or standing in performance of job duties.
• Full range of body motion required. Position requires reaching, bending, and handling objects and hands and/or fingers, talking and/or hearing, and sight.
• Ability to lift and carry objects weighing 25 pounds or less.
• Accomplish job duties using various types of equipment/supplies, e.g. pens, pencils, calculators, computer keyboard, telephone, etc.
• Ability to travel to other FoundCare locations and perform job duties.
• Ability to travel to other locations to attend meetings, workshops, and seminars, plus travel to other FoundCare departments and FoundCare conference rooms.

MINIMUM QUALIFICATIONS:

• High School Diploma with a minimum of six (6) months experience in a social service/human services advocacy role.
• Cultural sensitivity to diverse populations including the diversity of those infected with HIV and/or at risk of infection.
• Valid driver's license, automobile insurance, and a reliable automobile.
• Preferred: Bilingual – English and Haitian Creole/Spanish