Specialist - Financial Counselling (SEHA Fertility Center)

Role Overview

Specialist - Financial Counselling at SEHA Fertility Center. This role serves as a patient advocate to uninsured and underinsured patients and their families, helping them navigate healthcare costs, insurance coverage, and financial assistance programs while ensuring informed financial decisions and payment arrangements.

Role Purpose

Under the supervision of the Hospital Supervisor of Financial Counseling, the Financial Counselor supports patients and families in understanding their estimated patient responsibility, exploring payment options including prompt pay discounts and payment plans, and accessing UAE assistance programs. The role ensures patients make informed financial decisions and have sustainable payment arrangements in place.

Key Responsibilities

Authorization, Verification & Eligibility

• Perform Real Time Eligibility (RTE) checks to confirm and identify patient insurance coverage.
• Review the hospital's Health Information System (HIS) and payer websites to verify coverage.
• Contact patients, patient families, patient advocates, health care proxies, and physician offices to obtain insurance information as necessary.
• Work in collaboration with Patient Access and Pre-Admission Review staff to obtain demographic and insurance coverage information.
• Update guarantor and subscriber information in the system as needed.
• Runs daily reports, including the Registration by Location report, to identify previous day self-pay patient registrations.

Financial Assistance & Applications

• Gather documentation required for financial assistance applications.
• Assist with submission of financial assistance applications.
• Maintain ongoing communication with government agencies regarding the status of claims.
• Follow up with patients as necessary to obtain required documentation to ensure timely processing by the state.
• Advise patients of procedure costs and alternative sources of funding.

Patient Counseling & Communication

• Interview patients and families regarding their ability to obtain payment for hospital bills.
• Inform patients of payment options, including prompt pay discounts, payment plans, and UAE assistance programs.
• Help obtain coverage once patients are discharged.
• Assist families in applying for and dealing with third-party payor agencies regarding financial assistance.
• Work with health insurance providers to determine coverage and benefit limits.
• May arrange for referrals or second opinions.
• Provide thorough communication with patients and families using best practices and techniques.

Operations & Documentation

• Collect payments and post patient payments on accounts when appropriate.
• Document patient communications, the status of financial assistance applications, and payment plans in the hospital's Health Information System (HIS).
• Adhere to hospital and legal standards regarding Protected Health Information (PHI).
• Provide updates and act as a resource to hospital personnel including Patient Access, Case Management, and Social Services on financial matters as needed.

Patient Segmentation

• Collect information and provide counseling for Self-Pay patients.
• Collect information and provide counseling for Motor Vehicle Accident (MVA) patients.
• Collect information and provide counseling for THIQA Program patients.
• Collect information and provide counseling for International patients.
• Collect information and provide counseling for uninsured patients.

Qualifications & Experience

• 0-2 years of experience in financial counseling or related field.
• 0-2 years of relevant patient access experience.
• Familiar with standard concepts, practices, and procedures within the healthcare field.
• Demonstrated experience working with people of various educational and socioeconomic backgrounds preferred.

Skills & Competencies

• Extensive knowledge of healthcare revenue cycle systems.
• Thorough understanding of patient communication best practices and techniques.
• Strong verbal and written communication skills.
• Basic knowledge of Microsoft Office applications (Word, Excel, and Outlook) required.
• Knowledge of UAE financial assistance programs.
• Time management skills and attention to detail.
• Ability to plan and accomplish goals using experience and judgment.