Patient Financial Access Counselor - Yale New Haven Health

Overview:To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Patient Financial Access Counselor is responsible and accountable for coordinating the activities of the patient account from the point of initial contact through account resolution. This position will be the first face-to-face point of contact for our inpatients and will be able to provide services at all points of entry. Works closely with the patients, families, outside departments and third party payers to ensure compliance to individual requirements to expedite the timely collection of the accounts receivable and protect the patient and the Hospital from unnecessary financial loss. Is knowledgeable of various third party benefits and is proficient in understanding the electronic eligibility systems in order to educate patients of their benefits and attempt to collect balances due. Works independently and under varying circumstances to address the specialized needs of our self-pay, underinsured and undocumented resident patient population to identify resources for assistance that will protect the patient and the Hospital from unnecessary financial loss. Responsible to initiate the financial assistance application and navigate the patient through the process until resolution. This position is responsible for the effective outcome on accounts, being proficient and up to date in State and Federal regulations in order to successfully navigate various Social Service agencies (i.e. the Department of Social Services, Social Security, etc.) to expedite prompt resolution from the point of initial contact through final determination. Working in collaboration with the Care Management and Social Work Departments, this position formulates solutions to respond to non-clinical customer requests, resolving issues and obstacles while meeting the changing demands and priorities of the hospital and third party environments. Also responsible to identify trends and offer solutions to improve customer satisfaction and ensure a positive patient experience under sometimes difficult and life changing situations. Is proficient in all areas of In Patient Access including Emergency Department registration and responsibilities involve working all shifts including weekends and holidays at needed.

EEO/AA/Disability/VeteranResponsibilities:

• 1. COORDINATES ACTIVITIES OF ACCOUNT - Coordinates patient account from point of initial contact through account resolution. Understands all aspects of the patient's financial needs and ensures all billing requirements are accurate. Works closely with patients and/or family members to ensure all demographic and insurance information is accurate and complete while also responding and resolving non-clinical customer requests, issues and problems.
• 1.1 Review prior account history, identify any past trends. Establish a relationship with the patient, family or representative to address benefits and or balances that may cause potential financial issues. Determine the most efficient and effective course of follow up.
• 2. PROVIDES FINANCIAL COUNSELING to SELF-PAY AND UNDERINSURED PATIENTS and/or their representatives, utilizing guidelines for all state and federally funded medical assistance programs as well as Hospital based Free Care, Sliding Scale, Restricted Bed Funds and Emergency Medical for undocumented resident patient population. Works with patients to identify financial barriers and determine if they qualify for the Medication Assistance Program (MAP). Navigates the patient through the medical assistance application process and coordinates the activities of accounts. Works in collaboration with clinical staff in order to facilitate timely resolution.
• 2.1 Identifies potential financial assistance needs and advises patients and/or their representative of potential funding options available. Coordinates the inquiry into various state and federally funded programs such as Medicaid and Free Care. Begins the application process as dictated by City, State, and Federal regulations.
• 3. PROMOTES EXCELLENCE IN CUSTOMER SERVICE AND THE PAR CONCEPT THROUGHOUT THE ORGANIZATION. UPHOLDS THE STANDARDS OF PROFESSIONAL BEHAVIORS AT ALL TIMES - Works with hospital and health system staff throughout the organization to coordinate patient admissions in a way that exhibits service excellence and protects the patient and Hospital from unnecessary financial loss. Works with Hospital and Health System staff to promote service excellence while coordinating the medical assistance application process.
• 3.1 Provides educational information regarding third party requirements to patients, family members and other hospital staff as necessary. Maintains department incentives focused on enhancing the patient's experience at Yale New Haven Hospital.
• 4. UTILIZES A VARIETY OF SOFTWARE APPLICATIONS, REPORTS AND STATISTICAL DATA - Uses all applicable computer systems such as but not limited to, EPIC, On-line Eligibility, One Source and others to accomplish tasks and aid in the completion of the account. Maintains a comprehensive knowledge of various computer and software systems to support and effectively manage the daily operations and goals of the department. Manages changes in process in order to more efficiently service our customers and maintain high productivity standards.
• 4.1 Confirms eligibility and identifies problems of eligibility for inpatient admissions and other hospital services, ensuring that appropriate action is taken to resolve.
• 5. Utilizes excellent problem solving skills to resolve difficult account work queues.
• 5.1 Learns and retains workflows and nuances of various multidisciplinary areas throughout the department.
• 6. Performs other duties as assigned by Supervisor.
• 6.1 Participates in ongoing quality improvement efforts of the department, utilizing good problem solving methods and resourcefulness to address and resolve problems or to refer them to the appropriate person or department for resolution.

Qualifications:

EDUCATION

High school diploma or GED required. Associate degree or more than 2 years in a customer service environment preferred. Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM) or Certified Revenue Cycle Specialist (CRCS) through AAHAM required within 18 months of hire.

EXPERIENCE

Three (3) to four (4) years' experience in Access at YNHH or related environment with strong customer service and third party insurance background. Must demonstrate a strong working knowledge of all Access areas. Experience in resolving complex issues regarding patient accounts in a timely fashion.

LICENSURE

Certified Healthcare Access Associate (CHAA) through the National Association of Healthcare Access Management (NAHAM) or Certified Revenue Cycle Specialist (CRCS) through AAHAM required within 18 months of hire.

SPECIAL SKILLS

Self-directed, well organized and exhibiting excellent interpersonal and team oriented skills with the ability and desire to educate and advocate for patients and their families. Ability to identify and solve problems independently. Must be able to multitask and reprioritize in response to fluctuations in volume. Excellent interpersonal skills and ability to build rapport with a wide variety of individuals including clinical staff in order to meet the patient's needs. Excellent investigative, critical thinking and problem solving skills. Advanced computer skills and the ability to adapt to various programs/systems. Expert knowledge of Microsoft Office, Word, and Excel. Demonstrated proficiency in understanding registration work queues that affect workflow. Must be able to provide training or in-service to other staff and areas within the department and Hospital. Consistently demonstrates effective written and oral communication skills in coordination with the Standards of Professional Behavior with the ability to communicate complex requirements across clinical and financial disciplines.