Financial Counselor

ABOUT SHERIDAN MEMORIAL HOSPITAL

At Sheridan Memorial Hospital, we are proud to have achieved the 5-Star Quality Rating, ranking us in the top 13.6% of hospitals rated by the Centers for Medicare and Medicaid Services. We believe that our ability to deliver excellent healthcare begins with our people, and we are proud of our more than 750 skilled, experienced, and caring employees. We have over 100 providers who specialize in 25 areas of expertise. Our facility is state-of-the-art, and we are dedicated to providing outstanding patient-centered care.
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Nestled at the foothills of the Big Horn Mountains in northern Wyoming, spectacular scenery and outdoor activities abound. Our hospital has the latest technology and equipment comparative to that of many larger facilities, and you will find our staff is friendly, compassionate, caring, and courteous. We focus on creating and nurturing a workplace that encourages, recognizes, and rewards individual effort and creativity. Leadership is responsive to changing modes of healthcare delivery and adapts accordingly. We value effective communication and honesty and believe teamwork based on mutual respect is key to success.

JOB SUMMARY

Service excellence and a culture of kindness are priorities for Sheridan Memorial Hospital. The Financial Counselor is responsible for supporting Sheridan Memorial Hospital’s Revenue Cycle Team through providing accurate and compassionate counseling to the patient regarding insurance benefits, recommends alternative sources of payment, finding drug replacement programs, tracking payment of claims, and pre-authorization of services performed within the hospital and clinics per payor guidelines, in a timely manner. All while providing a 5-star experience, so the patient and provider can focus on healthcare.

ESSENTIAL JOB FUNCTIONS

• Counsels patients regarding insurance benefits and recommends alternative sources of payment by explaining responsibilities for services received, payment options and collections procedures to patients and parties responsible for payment.
• Demonstrates the ability to assertively pursue necessary information and to function independently to secure financial resolution on accounts.
• Contacts insurance carriers or other sources, including but not limited to, pharmaceutical companies, pharmacies, and acts as an advocate for the patient.
• Initiates process for collecting prepays due at time of service, performs follow-up to insure maximum collection is achieved.
• Responsible for financially clearing patients within Sheridan Memorial Hospital and Big Horn Health Network to obtain cash payment or determine eligibility for various government programs.
• Ability to educate patient on financial obligations not limited to insurance co-pays, deductibles, co-insurances, and out of pocket expenses for point of service collections.
• Obtains pre-authorizations/pre-certification per payer requirements for services rendered and ensures authorization information is documented appropriately in the system.
• Verifies physician orders are accurate, determines CPT, HCPCS and ICD-10 codes for proper Prior Authorization.
• Ability to understand and communicate insurance co-pays, deductibles, co-insurances, and out of pocket expenses for point of service collections.
• Communication is maintained with providers, clinical staff, and patient in relationship to authorization status.
• Works and assists with the billing department in researching and resolving rejected, incorrectly paid and denied claims as requested.
• Remains current with insurance requirements for pre-authorization and provides education within the departments and clinics on changes.
• Keep management informed of changes in authorization process, insurance policies, billing requirements, rejection or denial codes as they pertain to claim processing and coding. 
• Maintains knowledge of revenue cycle operations, third party reimbursement, local/state/federal regulations and medical terminology.
• Conducts all activities with knowledge and understanding of Sheridan Memorial Hospital's mission and values, regulatory compliance requirements, payer requirements, HIPAA privacy and security requirements, the overall revenue cycle procedures and the hospital's policies.
• Helps to maintain a professional atmosphere for patients, family members and staff.

POSITION QUALIFICATIONS

Education / Experience / License and Certifications

• Associate degree or equivalent experience required.
• Knowledge of CPT, HCPCS, and ICD-10 codes, preferred.
• Minimum of six months previous healthcare registration, billing and collections, financial counseling, and/or customer service experience, preferred.
• Certification may be required as regulatory requirements are in place.
• Knowledge of medical insurances, EMTALA regulations, hospital billing and collection processes, preferred.

Additional Skills

• Language Skills
  • Ability to read, analyze, interpret, and communicate proficiently in English.
  • Ability to effectively present information and respond to questions from providers, clinical staff, payors, and patients.
• Reasoning Abilities
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Ability to interpret a variety of instructions furnished in written, oral, or scheduled form.
• Computer Skills
  • Proficient with MS Office Suite including Word, Excel and PowerPoint.
  • Proficient with the EMR system.
• Other Knowledge, Skills, and Abilities
  • Ability to prioritize and perform multiple tasks with many interruptions.
  • Competently explains financial options and secures payment and/or payment plan from patients and/or guarantors. Ability to manage a fast pace environment.
  • Ability to manage multiple phone calls at once.
  • Ability to solve conflict.
  • Must possess excellent time management and organization skills with attention to detail.
  • Demonstrates critical thinking, creativity, and problem-solving.
  • Demonstrates the ability to maintain confidentiality.
  • Ability to write clearly and informatively.
  • Ability to cope with stressful situations and maintain a calm and professional demeanor.

Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products.

Pre-employment drug and alcohol screening is required.

APPLY HERE
 

Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to race, color, religion, age, sex, national origin, disability or protected veteran status.  If you would like more information about your EEO rights as an applicant under the law, please click here.