SHS-FINANCIAL COUNSELING SPECIALIST

General Purpose of Job:

Sparrow Financial Counseling Specialists will assist patients and family members in financial interactions related to their healthcare expenses. They primarily work with uninsured patients to identify eligibility for various coverage options through Medicare and Medicaid programs, Health Insurance Exchange plans, Sparrow Community Financial Aid, or other sources. They will assist patients with applying for coverage or educate them on options available to cover their healthcare needs. Financial Counseling Specialists will serve as both a Sparrow and Community resource. They will work closely with clinical providers (physicians, case managers, administrators) to provide financial guidance that supports the clinical needs of our patients.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Complete bedside, phone, and in-person patient interviews and screenings of uninsured patients receiving or seeking care within Sparrow Health System.
• Independently assess each patient situation and recommend the best solution for both patient and hospital to address healthcare expenses.
• Work with patients to identify potential coverage options from all sources; Government Programs, Insurance Exchange, COBRA, Crime Victim's Funds, Work Comp, Third-party Liability, Sparrow Financial Assistance, and others.
• Adhere to all department policies and procedures and utilize tools to properly document the statuses and next steps on patient accounts. This will ensure accounts are properly worked and financial counseling department efforts are accurately captured.
• Review and utilize Sparrow Financial Assistance Policy guidelines to make approval decisions on Financial Assistance Applications.
• Analyze data related to uninsured patients, charity care, bad debt, etc. to develop strategies for reducing the amount of uncompensated care provided by Sparrow.
• Complete applications for coverage through Michigan's Presumptive Medicaid Eligibility programs. Assist and advise patients in completing full Medicaid, Health Insurance Exchange (healthcare.gov), COBRA, Sparrow Financial Assistance, and other applications.
• Serve as CMS Certified Application Counselors (CAC's) as outlined in CMS requirements.
• Coordinate activity between Sparrow and on-site FIA (MARA) workers, and third-party Medicaid Eligibility companies to establish coverage under any available Medicaid programs quickly and efficiently.
• Research, analyze, and continually update information related to relevant funding sources for healthcare expenses. Educate patients regarding other community resources available for healthcare needs.
• Work with supply vendors to obtain low or no cost products for uninsured patients needing assistance.
• Assist uninsured patients and insured patients with large patient liabilities, high deductibles etc. understand options including self-pay discount, payment arrangements, financial assistance, and point of service payment requirements.
  
• Work with all parts of Sparrow Health System, including Sparrow Medical Group practices, Patient Support Services, and other clinical providers in arranging resources for uninsured patients.
• Provide cost estimates to patients seeking elective non-covered services or those facing a large patient liability after insurance.
• Complete community outreach and patient outreach to better manage the utilization of Sparrow resources for patients with no payment ability or insurance coverage. Assist community agencies and other healthcare providers in establishing coverage for uninsured individuals prior to needing hospital services.
• Provide education and make recommendations to patients about all forms of insurance coverage, what they might be eligible for, and how to obtain that coverage. Explain complicated coverage options in an easy to understand manner.