Providence Financial Counselor Clinic in Portland, Oregon
Providence St. Joseph Health is calling a Financial Counselor Clinics - (Mostly Telecommute - Portland Area Only) (Full-Time, Days) to our location in Portland, OR.
Please Note: This position requires in person attendance for meetings and other required tasks.
We are seeking a Financial Counselor Clinics who will have direct interaction with patients and their families during difficult times either on the phone or in person by providing financial, insurance, and payment information to assist them in resolving patient account balances. The Financial Counselor will in addition educate patients on various sponsorship programs available as well as assist and process financial assistance questionnaires.
Perform all duties in a manner that reflects Providence Health System mission, philosophy, and core values.
In this position you will:
Interview patient/guarantor to capture and understand key financial data to determine the patient’s general financial situation and ability to pay for balances due or qualify for financial assistance.
Process financial assistance application to determine Federal Poverty Level and financial eligibility for PH&S Financial Assistance Program.
Is part of a Financial Assistance Call Center taking inbound phone calls from patients and other departments as well as making outbound calls to uninsured clinic patients to evaluate their financial qualifications for ACA, Medicaid enrollment, or PH&S Financial Assistance.
Provide extensive knowledge of financial, insurance and payment information of various community and PHS resources to offer customer/patient in resolving account balances. (ie federal programs, pharmacy program, etc.)
Take ownership of accounts and prioritizes incoming cases and work-in-process caseload, using principles of stratification.
Maintain knowledge of state and federal Medicaid/Medicare assistance programs/requirements for all regions and ministries of PH&S.
Review and interpret billing statements, charge information, private or government insurance benefits, and other related information (for clinics and insurance companies) while resolving account balances.
Maintain high level of industry knowledge of insurance benefits and provides education to customers and peers regarding insurance benefits, managed care contract discounts and payment systems (DRG, Flat Fee, Per Diem, Charge Based).
Facilitate completion of Medicaid and ACA applications, eligibility and receipt by the state within designated timelines.
Provide education regarding charges and billing information to patients or insurance companies. Escalating charge discrepancies as appropriate to RBO contacts for care department review.
Assist customers in contacting third party providers or insurance companies to resolve issues as appropriate.
Negotiate payment arrangements.
Resolve patient issues and concerns that present at the on-site office, and communicates with the RBO in order to help resolve issues, as appropriate. Notifies RBO personnel of any re-billing, charge adjustments, refunding or collection intervention that needs to occur.
Utilize solid judgment and adhere to all policies ensuring the protection of confidential information related to patient demographics, medical information, diagnosis codes, etc. according to both internal and Federal HIPAA regulations and guidelines.
Act as resource to clinical departments, and other Providence Health System entities concerning the resolution of patient concerns in financial matters.
Escalate problematic or high-risk accounts to supervisor for assistance.
Required qualifications for this position include:
High school diploma or GED equivalent
3 or more years of experience in a hospital and/or clinic Business Office
Previous experience with medical and health plan terminology, CPT codes, ICD-9 coding
Experience in automated, computerized account follow-up system
Preferred qualifications for this position include:
3 or more years of experience in a hospital and/or clinic Business Office, preferably in a financial leadership role
Knowledge in reimbursement of health care accounts from insurance companies
About the department you will serve.
One Revenue Cycle (ORC) is the name adopted to reflect the Providence employees who work throughout Providence Health & Services (PH&S) in revenue cycle systems and structures in support of our ministries and operations in all regions from Alaska to California. ORC’s objective is to ensure our core strategy, One Ministry Committed to Excellence, is delivered along with the enhanced overall patient care experience (know me, care for me, ease my way) by providing a robust foundation of services, operational and technical support, and the sharing of comprehensive, relevant, and highly specialized revenue cycle expertise.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Patient Services
Req ID: 289385
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