Counselor-Finance

Overview


Ensures collection of patient balances, deductibles and co-pays in an accurate and timely manner. Serves as a resource to patients, families, and employees to discuss financial arrangements and properly explain patient financial obligation. Assists patients with any applicable financial assistance programs. Performs a treatment initiation approval process by review of ordered/prescribed services relating to insurance coverage policies and pre-certification/authorization requirements, while securing amicable payment arrangements. Performs other duties as assigned.


ob Responsibilities

Job Responsibilities

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Acts as a liaison with insurance companies to assist in obtaining insurance information
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Advises patients and family members with regards to next steps or processes for securing financial coverage.
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Together with the Director of Managed Care Contracting participate in negotiating one time single case agreements, including contractual provisions and rates with payers and coordinate implementation.
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Review and verify all charges flagged as pre-transplant/evaluation charges for potential recipients and/or waitlisted patients by managing related EPIC workqueue(s).
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Collaborates with Finance staff and Managed Care Contracting staff to ensure proper billing of accounts under global contracts/Center of Excellence agreements
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Expedites patient flow through prompt and courteous service.


Specifications

Experience

Description Minimum Required Preferred/Desired


Three years of business related office experience with one of those years being in a clinical setting.


Five years of business experience in a clinical setting environment. Front-end collections experience desired. One year minimum experience performing pre-certification/authorization functions within a hospital and/or clinic environment.


Education

Description Minimum Required Preferred/Desired


High school diploma or equivalent required. Skill in communicating clearly and effectively using standard English in written, oral, and verbal format to achieve high productivity and efficiency. Three years of business experience in a clinical setting environment.


Associates degree or two years of college level courses.


Training

Description Minimum Required Preferred/Desired


Special Skills

Description Minimum Required Preferred/Desired


Excellent customer service and communication skills. Ability to speak, articulate, and be understood clearly. Skill to write legibly and record information accurately as necessary to perform job duties. Basic computer skills to include MicroSoft office literacy knowledge required. Ability to perform basic math computation. Dealing with confrontational issues and high stress situations with patients, family, and physicians. Strong quantitative, research, analytical, problem solving, and organizational skills. Must have team - oriented work ethic with strong interpersonal skills. Prioritizes and performs work responsibilites independently or with a minimum of supervison.


Knowledge of EPIC application of cash postings and registration processes. Insurance verification processes using Real Time Eligibility, Passport Communications, and additional on-line verification processes. Knowledge of pre-certification requirements and guidelines. Knowledge of medical coding methodologies.


Licensure

Description Minimum Required Preferred/Desired


CHAA;RHIT


Reporting Relationships

Does this position formally supervise employees? If set to YES, then this position has the authority (delegated) to hire, terminate, discipline, promote or effectively recommend such to manager.