The Assistant Manager, Financial Counseling will assist the Senior Director, Outpatient Services in the daily operations of financial service efforts, particularly (as it relates to verification of benefits, rate negotiations, etc.), and will oversee the day-to-day supervision of assigned staff. The incumbent performs the quality control function for outpatient accounts and medical programs, ensuring all pertinent information is available and accurately documented, allowing for timely and efficient billing. This includes generating weekly status reports, communication with multiple departments, monitoring accounts for proper documentation of third-party review notification, authorizations, insurance verifications, collection of deposits and self-pay balances, securing reimbursement methods of non-insured admits, computer update of accounts and the collection of verification of relevant patient data. This position will interact with patients, families, clinicians, and administrative staff and serve as a resource to the Care Center team, so an emphasis is placed on adhering to high standards of customer service.

1. Provide daily supervision of Financial Counselor staff, including orienting, training, and monitoring proficiency of staff; conducting timely staff performance evaluations, including initial evaluations, annual appraisals, and follow-ups resulting from coaching or disciplinary actions; managing daily staff schedules to ensure appropriate coverage; and meeting regularly with Financial Counselor staff on all issues related to clearance. Creating a positive working environment and setting high work and ethical standards by providing leadership and a positive example to staff and customers.
2. Verify, analyze, interpret, and document patient health insurance coverage, health plan provisions or other third-party payment plan arrangements for outpatient.
3. Secure authorization for outpatient and day treatment programs. Evaluate funding sources and alternate funding sources of payment, following through until sources are exhausted or obtained.

4. Interviews and counsels underinsured and uninsured patients to determine financial eligibility. Obtains necessary referrals, authorization and pre-certifications as needed.
5. Provides cost estimates to patients, physicians’ offices, and payers as requested agencies using negotiated rates for outpatient and day programs. Determines patient liability, establishes, and coordinates payment arrangement information with Patient Accounting. Ensures accurate financial categorization, identifies appropriate guarantor, and updates system information accordingly.
6. Monitor insurance benefit thresholds (concurrent review) and facilitate the acquisition of additional authorization as directed by the Clinical Care team.
7. Assist with the tracking of departmental reports, including the Bad Debt report, and communicate solutions to the Senior Director and Patient Accounting.
8. Support the Senior Director, Outpatient Services with developing, implementing, and maintaining Financial Counselor departmental training manuals, policies, and procedures for verification of benefits, rate negotiation, and performance standards for staff.
9. Monitor patient insurance clearance for completion and audit Epic work queue to ensure complete and accurate information is entered into the system.
10. Develop and maintain a quality assurance and quality improvement program to monitor compliance with procedures, quality of data, and effectiveness of systems while working with subordinates and the user community to continually improve the process and performance. Alerts Medical Care Center Director to patterns in problem areas to initiate situation resolution.
11. Verifies and assures all accounts are prepared for billing to include supporting documentation and third-party billing requirements, and authorization codes. Ensures that all third-party identification codes are used correctly. Ensures timely processing of all accounts in the business office within established time frames by monitoring appropriate turnaround times.
12. Attends and actively participates in department and facility meeting and classes, including annual fire, safety, and disaster programs.

EDUCATION:
• Associate’s degree required. 2 or more years of relevant experience above the minimum required may be substitute for the education requirement at the discretion of the Senior Director, Outpatient Services.
• Bachelor’s degree in human services related field or health care administration preferred.

EXPERIENCE:
• Minimum 5 years of relevant experience required, to include
o Experience providing administrative support and patient services, such as registration and scheduling, in a healthcare setting.
o Minimum 2 years of experience managing Epic and clinical operations.