Sr., Financial Counselor

Are you looking for a career that offers both purpose and the opportunity for growth? Parkland Community Health Plan (PCHP) is a proud member of the Parkland Health family.  PCHP is a Medicaid Managed Care Organization servicing Texas Medicaid and CHIP in the Dallas Service Area.  PCHP works to fulfill of our mission by empowering members to live healthier lives.  By joining PCHP, you become part of a team focused on innovation, person-centered care, and fostering stronger communities. As we continue to expand our services, we offer opportunities for you to grow in your career while making a meaningful impact. Join us and work alongside a talented team where healthcare is more than just a job—it’s a passion to serve and improve lives every day.

PRIMARY PURPOSE

Serves as a program expert and lead resource for immediate supervisor regarding all types of funding programs, in order to ensure that all Parkland patients are screened and qualified for assistance.MINIMUM SPECIFICATIONS

Education :

• High School Diploma / GED
• Two Years of College Preferred

Experience :

Equivalent Education and / or Experience

Certification / Registration / Licensure :

Required Test for Placement

Skills or Special Abilities :

1.    Must be able to interview patients to determine their financial eligibility.

2.    Must be able to interview patients to assess their financial eligibility.

3.    Must demonstrate proficiency in using personal computers and standard office equipment.

4.    Must have experience with medical software.

5.    Must possess a solid understanding of public assistance programs and the necessary documentation.

6.    Must have a thorough knowledge of third-party payors and insurance verification procedures.

7.    Must understand managed care and insurance contractual agreements.

8.    Must be detail-oriented, possess basic mathematical skills, and demonstrate strong analytical abilities to resolve financial issues involving various stakeholders, including third-party payors, physicians, patients, and the healthcare system.

9.    Must demonstrate a positive attitude and possess strong verbal and written communication skills while maintaining professionalism in both appearance and demeanor.

10.    Must be able to handle potentially stressful situations and manage multiple tasks simultaneously, including instructing and counseling patients about Parkland's payment policies and public assistance programs.

11.    Must demonstrate strong organizational and planning skills with attention to detail, maintaining productivity during financial screenings.

12.    Must be able to communicate effectively with patients, government entities, and Parkland staff.

13.    Must be capable of solving problems within established policies and procedures.

14.    Must complete any additional job-related training that is offered.

15.    Must be able to interact with patients and their families effectively.

16.    Must be a team player, collaborating with nurse navigators, referral coordinators, and other Patient Financial Services team members.

17.    Bilingual in Spanish is preferred.

18.    Proficiency in the Microsoft Office Suite is preferred.

Responsibilities

2.    Acts as the primary resource for the immediate supervisor to support financial counselors with training, complex financial assessments, and monitoring workflow issues and dwell times as needed.

3.    Reviews patient accounts and financial files to verify that the appropriate funding program sources are pursued, the application process is completed accurately and on time, and accounts are billed correctly.4.    Screens patient demographic and financial documentation to identify appropriate funding program(s).

5.    To ensure all patients who are qualified for assistance are properly instructed and receive benefits.

6.    Verify and obtain insurance benefits, forward referrals, and pre-certifications to clinical staff to ensure that patient information is complete and accurate, and ensure that Parkland’s financial viability is secure at the most basic level.

7.    Assists patients in completing the certification process with all appropriate public funding source agencies to ensure applications are complete, deadlines are met, and the certification process is expedited before the patient’s discharge.

8.    Sets up and encourages applicants to keep appointments to ensure the patient completes the process to qualify for financial assistance—documents actions taken in the hospital accounting system.

9.    Communicates to the patient their financial responsibility and collects co-pays and / or unpaid balances.

10.    Provides patients with billing information as required. Enters payments into the computer system to document financial transactions / payment posting. Balances cash drawer at the end of each day.

11.    Assign appropriate coverage to accounts, including outside agencies when applicable, to ensure patient financial responsibilities are fulfilled.

12.    Performs registration functions, including verifying patient identification, patient demographics, and all third-party funding payors, to ensure Parkland’s financial viability is secured at the most basic level.

13.    Distributes, offers explanations, and obtains signatures and dates on all required forms as needed.

14.    Attaches all appropriate coverages, prioritizes correct filing order, and documents actions taken in the hospital accounting system.

15.    Tracks productivity and provides cumulative reports daily, weekly, or monthly, as required by supervisor and / or manager.

16.    Monitors and administers all assigned accounts until the patient’s application, certification, and / or denial process or review is complete, all appropriate coverages are attached, and the coverages are prioritized correctly for proper billing.

17.    Maintains a positive working relationship with contacts at all agencies and funding programs, patients, insurance companies, government entities, clinical personnel, other Financial Counselors, and management, to promote teamwork, cooperation, and a positive public image for Parkland.

18.    Serves as a positive role model for staff and patients, demonstrates strong interpersonal and persuasive abilities to ensure client compliance and cooperation with state / federal agencies. Accepts constructive criticism and integrates suggestions in effective ways.

19.    Stays abreast of the latest developments, advancements, and trends in financial assistance by attending seminars / workshops, reading professional journals, and actively participating in professional organizations.

20.    Completes all Parkland-based training and attends staff meetings as required by management.

21.    Integrates knowledge gained into current work practices.

22.    Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact Patient Financial Services.

23.    Establishes strong internal controls to guarantee adherence to applicable state and federal regulations, alongside the standards set by accreditation organizations and different health plans in the federal, state, and private sectors.

24.    Seeks advice and guidance as necessary to ensure proper understanding.

25.    Identifies ways to improve work processes and improve customer satisfaction.

26.    Making recommendations to supervisors, implementing changes, and monitoring outcomes aligned with the department and Parkland's goals are expected.

27.    Performs other work as requested that is reasonably related to the employee’s position, qualifications, and competencies

Job Accountabilities

1.  Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.

2.  Stays abreast of the latest developments, advancements, and trends in the field by attending seminars / workshops, reading professional journals, actively participating in professional organizations, and / or maintaining certification or licensure. Integrates knowledge gained into current work practices.

3.  Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding.

Parkland Community Health Plan (PCHP) prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.