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Financial Counselor - Behavioral Health 155

Oakland, California, United States

Financial Counselor - Behavioral Health 155

  • Oakland, California, United States

Founded in 1965, Telecare is a rapidly growing mental health care company dedicated to making a difference for our clients, the community, and our employees. We offer an array of mental health services to adults with serious mental illness. We partner with public sector entities and behavioral health organizations and have over 155 programs and over 4,300 employees across the country. And we 're growing all the time! When you work at Telecare, you help to empower thousands of individuals every day in their journeys of recovery.

As a part of the Telecare Family, Heritage Psychiatric Health Facility (PHF) is a 26-bed hospital providing acute psychiatric treatment to adults over the age of 18.

Employment Status: Full-Time

Shift: AM as needed

Days: Monday - Friday

POSITION SUMMARY
The Financial Counselor is responsible for performing activities related to confirming and securing reimbursement for services provided to members served who are admitted to or discharged from the program; educating members served with navigation and interpretation of insurance processes; and offering repayment agreements or other financial options related to resolving account balances of members served. The Financial Counselor works in tandem with program clinical staff to ensure demographics of members served are accurate, authorizations are in place, and appeals for denied claims are submitted. The Financial Counselor works to meet or exceed upfront collection standards by staying proactively involved with accounts from pre-registration to discharge. This includes, but is not limited to census confirmation, verification of eligibility and benefits, authorization follow up, copayment collection, and members served statements.

ESSENTIAL FUNCTIONS
• Demonstrates the Telecare mission, purpose, values, and beliefs in everyday language and contact with internal and external stakeholders
• Demonstrated ability to multitask and stay organized as well as the capacity to work with sophisticated automated billing system as well as manual billing systems
• Deciphers insurance coverage and benefits to ensure accuracy of all revenue cycle activities for assigned program
• Updates the billing system to reflect accurate insurance status of members served
• Reviews daily census for all members served to determine Revenue Cycle intervention appropriateness
• Calculates liabilities for members served if applicable; provides face to face and/or telephone financial counseling for members served and/or their families, with demonstrated regard for dignity of all members served/families, focusing on:
o Confirming accuracy of demographic and insurance information of members served
o Explaining insurance benefits and copayment liabilities (if applicable)
o Collecting liabilities of members served
o Assisting with financial repayment agreements for those in need
o Responding to concerns/needs/responses of members served accordingly
• Participates as an active member of the Financial Review Committee and provides support as necessary for corporate billing activities
• Actively promotes and supports the ongoing education of co-workers, program, and regional staff to facilitate accurate, timely, and efficient methods of reporting and maintaining census and billing data
• Functions as primary point of contact between assigned program and corporate office; serves as the point person for all program activities related to revenue cycle
• Maintains and expands knowledge base of payer requirements for both contracted and non-contracted entities
• Generates reports to identify missing authorizations and informs clinical staff of missing/expiring authorizations
• Presents overview of members served who are at risk from the Revenue Cycle perspective (e.g., Medicare members reaching 100 days' limit, Kaiser authorizations expiring)
• Coordinates revenue cycle activities; ensures members served billing is accurate and Avatar data is clean to reduce denied claims
• Works closely and partners with program administration to coordinate Revenue Cycle activities to minimize negative financial impact to, and protect the financial integrity of the program
• Actively collaborates with program staff, providing input via reporting observations, concerns, and asking appropriate questions; maintains effective rapport with operations staff, aiding in proper discharge planning and ensuring all financial assessments are clear, updated, and thorough
• Maintains effective rapport with program staff while keeping management abreast of issues identified while performing job duties (e.g., payer changes, authorization issues, system issues, etc.)
• Informs program clinical and operations staff of liabilities of members served and barriers to compliance
• Assumes responsibility for taking initiative in solving problems and takes a proactive approach in removing obstacles that hinder work production
• Generates aging report to assist with identifying accounts that need collection calls, and makes the call
• Offers suggestions and input to help establish, provide, and maintain reporting tools for payer reimbursement activities and trends
Duties and responsibilities may be added, deleted, and/or changed at the discretion of management.

QUALIFICATIONS
Required:
• High school diploma and five (5) years of experience working in hospital service access, clinical service access, physician office, or billing and collections; or an Associate's degree in a healthcare related field and one year of healthcare customer service experience
• Ability to analyze data, perform multiple tasks, and work independently
• Ability to develop and maintain professional, service-oriented working relationships with members served, clinicians, social workers, and supervisors
• Understanding of Medicare, Medi-Cal/Medicaid, and commercial insurances
• A Must be at least 18 years of age
• Must be CPR, Crisis Prevention Institute (CPI), and First Aid certified on date of employment or within 60 days of employment and maintain current certification throughout employment
• All opportunities at Telecare are contingent upon successful completion and receipt of acceptable results of the applicable post-offer physical examination, 2-step PPD test for tuberculosis, acceptable criminal background clearances, excluded party sanctions, and degree or license verification. If the position requires driving, valid driver license, a motor vehicle clearance, and proof of auto insurance is required at time of employment and must be maintained throughout employment. Additional regulatory, contractual, or local requirements may apply.

Preferred:
• Advanced knowledge of insurance benefits, previous financial counseling, or collection experience

SKILLS
• Computer literacy and demonstrated capacity to work with Microsoft Excel and Word
• Analytical and problem solving skills
• Ability to understand complex reimbursement structures and governmental regulations
• Ability to work and communicate effectively with program staff, management staff, government representatives, and customers
• Excellent oral and written communication skills

PHYSICAL DEMANDS
The physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

The employee is occasionally required to stand, walk, reach, twist, bend, and lift and carry items weighing 25 pounds or less as well as to constantly sit and do simple grasping occasionally. The position requires manual deviation, repetition, and dexterity.

EOE AA M/F/V/Disability

Equal Opportunity Employer Description
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
Pay Transparency Policy Statement
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.