Job Overview:
The Financial Compliance Counselor is responsible for providing patients with a positive financial experience by helping patients navigate & understand insurance benefits and out-of-pocket responsibility. Creates complex financial estimates accurately and efficiently for patients shopping for healthcare services and for services scheduled at a TriHealth hospital facility, ambulatory site or provider offices; estimates can also include providers for which we do not bill for, adding to the challenge. Coordinating financial clearance with insurance companies, providers and patients in an inbound/outbound call center setting. Make outreach calls to provide education to patients on insurance benefits, financial responsibility and financial assistance options, with a special focus on Out of Network plans. Ensures compliance with guidelines set by government programs and TriHealth policies, such as the federal regulations Price Transparency and the No Surprises Act.
Job Requirements:
High School Diploma or GED Degree or GED (Required)
3 - 4 years customer service experience (Required)
1 - 2 years of Clerical, Healthcare, Finance, and/or insurance industry (Required)
General Studies
Ability to operate multiple computer applications
Excellent verbal and written skills
Effective problem solving and critical thinking skills
Job Responsibilities:
Anticipates customer needs, problem solving skills, consistent and positive interactions with patients, internal customer and co-workers. Meets individual goal for call quality as measured by monthly call audits.
Completes assigned workqueues/encounters to meet team deadlines.
Educates customers on coverage benefits, financial responsibility and provide consents as needed within policy guidelines, with timeliness being a key factor.
Exhibits knowledge and understanding of insurance benefits, financial assistance programs including, HCAP/TriHealth Financial Assistance guidelines and pricing.
Meets competency guidelines pertaining to government and TriHealth policy guidelines (Price Transparency, NSA, 501r, HCAP, etc…)
Accurately and timely documents benefits, estimates, and account notes in Epic and presents to patients in a timely fashion.
Working Conditions:
Bending -
Climbing - Rarely
Concentrating - Consistently
Continuous Learning -
Hearing: Conversation -
Hearing: Other Sounds -
Interpersonal Communication - Frequently
Kneeling -
Lifting Lifting 50+ Lbs. - Rarely
Lifting Pulling - Occasionally
Pushing - Consistently
Reaching -
Reading - Consistently
Sitting - Consistently
Standing - Occasionally
Talking -
Thinking/Reasoning - Frequently
Use of Hands -
Color Vision -
Visual Acuity: Far -
Visual Acuity: Near -
Walking - Occasionally
TriHealth SERVE Standards and ALWAYS Behaviors
At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following:
Serve: ALWAYS...
• Welcome everyone by making eye contact, greeting with a smile, and saying "hello"
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist
• Refrain from using cell phones for personal reasons in public spaces or patient care areas
Excel: ALWAYS...
• Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met
• Offer patients and guests priority when waiting (lines, elevators)
• Work on improving quality, safety, and service
Respect: ALWAYS...
• Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone's opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
Value: ALWAYS...
• Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
Engage: ALWAYS...
• Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community