Job Summary:
The Financial Counselor will serve the Des Moines area within the Department of Obstetrics and Gynecology will serve as a resource for complex In-Vitro Fertilization, Reproductive Endocrinology, and other OBGYN billing issues and will financially counsel patients. Successful candidates for this role should possess outstanding customer service skills, strong leadership abilities and excellent communication skills. A large part of this role is working with our diverse range of internal and external customers including our patients and their families, insurance companies and third-party vendors. Candidates will be expected to maintain "Service Excellence" standards for all customer groups by demonstrating compassion, empathy, respect for patients' rights as well as their privacy. Staff will utilize tools and processes to make independent decisions and maintain a high level of integrity regarding patient rights. Strong analytical skills are necessary, along with clinical knowledge to ensure effective and compliant organizational/department/unit operations for the Obstetrics and Gynecology department. The Financial Counselor must have a demonstrated ability to prioritize, multi-task & quickly change focus in fast-paced team environment. This role is expected to provide accurate and comprehensive information (verbally and written) to various persons regarding all third-party interactions, patient billing and customer service activities. Staff are expected to utilize exceptional problem and conflict resolution skills while maintaining confidentiality and professionalism.
In this position you will:
• Provide developmental and administrative assistance and expertise for data analysis, trending, and payor regulations/policies for the IVF process. Communicate trends and payor policies to clinical staff.
• Implement new processes developed by management and the IVF department to ensure processes are operating effectively and efficiently; make recommendations based on analysis of data.
• Gather and respond to requests for information in response to benchmark surveys or questionnaires required by external agencies.
• Verify benefits and provide financial counseling to patients and families to ensure they are advised of their financial obligations, with appropriate financial arrangements made according to the hospitals financial policy.
• Provide financial counseling via phone and/or in-person based on the patient's liability. Provide payment options including offsite financing.
• Identify trends and/or work processes for potential process improvements.
• Review and analyze report data to provide status updates to leadership.
• Communicate with providers, payers, patients, internal departments, co-workers, and management to resolve issues and take appropriate actions.
• Perform registration duties including verifying insurance coverage.
• Create episodes of care for the clinic and billing teams on donor, recipient, and gestational carrier accounts through Special Programs.
• Create bundling accounts for self-pay patients.
• Monitor clinic schedule for self-pay patients, collect monies as needed.
• Obtain Prior Authorizations for infertility care.
• Initiate and compile self-pay estimates Charge Adjustment Review Team (CART) forms for out of country or self pay patients.
• Attend weekly IVF team meetings if needed.
• Document and process map new procedures, such as CART, collaborating with the clinical and billing teams. Aid with multiple Epic Work queues.
• Monitor Epic and email in-baskets for the fertility financial team.
• Work with hospital finance to set prices and bundled payment for infertility treatments.
• Work with outside agencies for donor eggs, donor sperm, gestational carriers.
• Set up non UIHC patients for satellite monitoring, send bills monthly.
• Maintain the Warranty spreadsheet.
• Work with UIHC payor relations to complete yearly insurance contracting.
• Make pricing changes to multiple documents yearly. Maintain CPT spread sheets.
• Assist with peer-to-peer communications.
• Assist patients with questions on their statements and EOBs.
• Keep current on industry knowledge, skills, and certifications to serve as a resource to employees and to conduct job duties.
The information contained herein is not intended to be an exhaustive list of all responsibilities required of individuals performing the job.
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