Financial Counselor-Full Time-Days
Cape Fear Valley Health · Hoke, NC · 1 mo ago
FinanceFull-time
We need to output HTML fragment with headings for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We must not repeat job title. Must preserve all substantive info, no boilerplate. Remove cookie/navigation/legal/EEO etc. Also remove duplicated lines. Must not create sections with placeholder text.
We need to parse the posting.
Given text:
Facility Hoke Hospital Location Raeford, North Carolina Department PFS Financial Clearance Job Family Clerical Work Shift Days (United States of America) Summary Receives accounts and/or schedules for review and work-up regarding preadmission, admission, or add-on procedures, and services. Interviews patients for necessary account follow-up, to obtain accurate and detailed demographic, and financial information. Verifies insurance information, benefits, and initiates medical certification; reviews medical necessity, and assures that authorization is noted on file with supporting reference for the appropriate procedure, service, and/or patient status. Receives, reviews, and completes necessary follow-up for encounter denials. Notifies patients of financial responsibility; explains and reviews insurance coverage, and collects patient’s responsibility via phone, or at time of service, to include initiation of payment arrangements if needed, or as required. Major Job Functions The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time: Contacts and interviews patients, responsible parties and insurance companies regarding hospital or ambulatory service to secure insurance benefits.Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (EDI transactions, web access and by calling payers) and documenting information within the appropriate registration system, supporting with reference number.Determines the need for appropriate service authorizations (pre-certifications, 3rd party authorizations, referrals) and contacts the payer, physician and/or case management/utilization review personnel, as necessary. Ensure authorization matches test(s) orderedPre-registers the patient for upcoming visit(s) including validating/obtaining and entering demographic, financial, and insurance information.Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).Informs patient/guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.Calculates patient liabilities and provides financial education, referring the patient to resource counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt. Assists patient with payment arrangements as needed for remaining balance.Properly screens appropriate patients for market insurance.Obtains signed physician orders for scheduled tests and procedures from physicians/offices for testing and procedures, and scans into electronic record.Completes appropriate follow-up on insurance denials and initiates appeal, retro-authorization, etc. as needed.Assists insurance companies, physician, and physician practices, and or hospital departments with patient information in accordance with HIPAA guidelines.Meets or exceeds accuracy standard goal determined by Patient Access Leadership; Ensures integrity of patient accounts by working error reports daily, entering accurate data, and documenting all attempts made to collect and or obtain missing documentation.Other duties as assigned Minimum Qualifications The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job: Education And Formal Training High school graduate or equivalent requiredAssociates Degree in Business or Health Care Administration and/or Computer Technology preferredPatient Access Specialist certification (CPAS) required within 1 year of employment Work Experience 1 year insurance/clerical experience within a hospital or medical office setting Knowledge, Skills, And Abilities Required Proficiency in reading, writing, and speaking the English languageKnowledge of insurance and collection of paymentsKnowledge of Medical TerminologyKnowledge of Microsoft softwareExcellent verbal and written communication skills, customer service skills and problem-solving abilitiesAbility to appropriately handle complexity and stress with the changing needs of the patients, families, visitors, and the Health System.May be required to periodically rotate shifts and regular days offAll system employees must have the flexibility to meet the department hours of operation Physical Requirements Must be able to communicate orally, see, and hear to collect informationMust have dexterity to operate office equipment.Position operates in an office, call center environmentThe incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen.The noise level is low to moderate.Bends, reaches, pushes and pulls file drawers to file records and reports.Regularly lift or move up to 10 pounds, frequently lift or move up to 25 pounds and occasionally lift or move up to 50 pounds. Required Licenses And Certifications CPAS - Healthcare Business Insights Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity
We need to extract sections: About the role (summary), Responsibilities (major job functions), Requirements (minimum qualifications?), Qualifications (maybe education?), Skills (knowledge, skills, abilities), Benefits (none?), Pay (none?), Schedule (maybe shift info?).
We must not create sections with placeholder text like "not specified". So only include sections where we have real content.
We have:
- Summary: "Receives accounts and/or schedules for review and work-up regarding preadmission, admission, or add-on procedures, and services. Interviews patients for necessary account follow-up, to obtain accurate and detailed demographic, and financial information. Verifies insurance information, benefits, and initiates medical certification; reviews medical necessity, and assures that authorization is noted on file with supporting reference for the appropriate procedure, service, and/or patient status. Receives, reviews, and completes necessary follow-up for encounter denials. Notifies patients of financial responsibility; explains and reviews insurance coverage, and collects patient’s responsibility via phone, or at time of service, to include initiation of payment arrangements if needed, or as required."
That's about the role.
- Major Job Functions: list of duties. We can treat as Responsibilities.
- Minimum Qualifications: includes Education And Formal Training, Work Experience, Knowledge, Skills, And Abilities Required, Physical Requirements, Required Licenses And Certifications.
We need to map to sections: Requirements (maybe education/experience), Qualifications (maybe certifications?), Skills (knowledge, skills, abilities). Benefits, Pay, Schedule: we have shift info: "Work Shift Days (United States of America)"? Actually earlier: "Work Shift Days (United States of America)" appears in header: "Facility Hoke Hospital Location Raeford, North Carolina Department PFS Financial Clearance Job Family Clerical Work Shift Days (United States of America)". That seems to indicate shift days but not specific. Also later: "May be required to periodically rotate shifts and regular days off". Also "All system employees must have the flexibility to meet the department hours of operation". That's schedule info but not specific times. Might be considered schedule content. However we should not create a Schedule section if it's vague like "May be required to periodically rotate shifts and regular days off". That's still specific content about shift flexibility. It's not placeholder like "TBD". It says may be required to periodically rotate shifts and regular days off. That's substantive. So we could include a Schedule section with that info.
Pay: No mention of salary, pay, compensation. So we should not create Pay section.
Benefits: No mention of benefits. So not include Benefits.
Now we need to decide which headings to use: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule.
We have content for About the role (summary). Responsibilities (major job functions). Requirements (maybe education and experience). Qualifications (maybe certifications?). Skills (knowledge, skills, abilities). Schedule (shift flexibility). We'll not include Benefits or Pay.
We must not repeat job title as heading. Good.
We need to output only HTML fragment, no /, no markdown fences.
We'll produce something like:
items.
Now Requirements: The Minimum Qualifications section includes Education And Formal Training, Work Experience, Knowledge, Skills, And Abilities Required, Physical Requirements,
for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. We must not repeat job title. Must preserve all substantive info, no boilerplate. Remove cookie/navigation/legal/EEO etc. Also remove duplicated lines. Must not create sections with placeholder text.
We need to parse the posting.
Given text:
Facility Hoke Hospital Location Raeford, North Carolina Department PFS Financial Clearance Job Family Clerical Work Shift Days (United States of America) Summary Receives accounts and/or schedules for review and work-up regarding preadmission, admission, or add-on procedures, and services. Interviews patients for necessary account follow-up, to obtain accurate and detailed demographic, and financial information. Verifies insurance information, benefits, and initiates medical certification; reviews medical necessity, and assures that authorization is noted on file with supporting reference for the appropriate procedure, service, and/or patient status. Receives, reviews, and completes necessary follow-up for encounter denials. Notifies patients of financial responsibility; explains and reviews insurance coverage, and collects patient’s responsibility via phone, or at time of service, to include initiation of payment arrangements if needed, or as required. Major Job Functions The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time: Contacts and interviews patients, responsible parties and insurance companies regarding hospital or ambulatory service to secure insurance benefits.Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (EDI transactions, web access and by calling payers) and documenting information within the appropriate registration system, supporting with reference number.Determines the need for appropriate service authorizations (pre-certifications, 3rd party authorizations, referrals) and contacts the payer, physician and/or case management/utilization review personnel, as necessary. Ensure authorization matches test(s) orderedPre-registers the patient for upcoming visit(s) including validating/obtaining and entering demographic, financial, and insurance information.Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance.Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).Informs patient/guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration.Calculates patient liabilities and provides financial education, referring the patient to resource counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt. Assists patient with payment arrangements as needed for remaining balance.Properly screens appropriate patients for market insurance.Obtains signed physician orders for scheduled tests and procedures from physicians/offices for testing and procedures, and scans into electronic record.Completes appropriate follow-up on insurance denials and initiates appeal, retro-authorization, etc. as needed.Assists insurance companies, physician, and physician practices, and or hospital departments with patient information in accordance with HIPAA guidelines.Meets or exceeds accuracy standard goal determined by Patient Access Leadership; Ensures integrity of patient accounts by working error reports daily, entering accurate data, and documenting all attempts made to collect and or obtain missing documentation.Other duties as assigned Minimum Qualifications The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job: Education And Formal Training High school graduate or equivalent requiredAssociates Degree in Business or Health Care Administration and/or Computer Technology preferredPatient Access Specialist certification (CPAS) required within 1 year of employment Work Experience 1 year insurance/clerical experience within a hospital or medical office setting Knowledge, Skills, And Abilities Required Proficiency in reading, writing, and speaking the English languageKnowledge of insurance and collection of paymentsKnowledge of Medical TerminologyKnowledge of Microsoft softwareExcellent verbal and written communication skills, customer service skills and problem-solving abilitiesAbility to appropriately handle complexity and stress with the changing needs of the patients, families, visitors, and the Health System.May be required to periodically rotate shifts and regular days offAll system employees must have the flexibility to meet the department hours of operation Physical Requirements Must be able to communicate orally, see, and hear to collect informationMust have dexterity to operate office equipment.Position operates in an office, call center environmentThe incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen.The noise level is low to moderate.Bends, reaches, pushes and pulls file drawers to file records and reports.Regularly lift or move up to 10 pounds, frequently lift or move up to 25 pounds and occasionally lift or move up to 50 pounds. Required Licenses And Certifications CPAS - Healthcare Business Insights Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity
We need to extract sections: About the role (summary), Responsibilities (major job functions), Requirements (minimum qualifications?), Qualifications (maybe education?), Skills (knowledge, skills, abilities), Benefits (none?), Pay (none?), Schedule (maybe shift info?).
We must not create sections with placeholder text like "not specified". So only include sections where we have real content.
We have:
- Summary: "Receives accounts and/or schedules for review and work-up regarding preadmission, admission, or add-on procedures, and services. Interviews patients for necessary account follow-up, to obtain accurate and detailed demographic, and financial information. Verifies insurance information, benefits, and initiates medical certification; reviews medical necessity, and assures that authorization is noted on file with supporting reference for the appropriate procedure, service, and/or patient status. Receives, reviews, and completes necessary follow-up for encounter denials. Notifies patients of financial responsibility; explains and reviews insurance coverage, and collects patient’s responsibility via phone, or at time of service, to include initiation of payment arrangements if needed, or as required."
That's about the role.
- Major Job Functions: list of duties. We can treat as Responsibilities.
- Minimum Qualifications: includes Education And Formal Training, Work Experience, Knowledge, Skills, And Abilities Required, Physical Requirements, Required Licenses And Certifications.
We need to map to sections: Requirements (maybe education/experience), Qualifications (maybe certifications?), Skills (knowledge, skills, abilities). Benefits, Pay, Schedule: we have shift info: "Work Shift Days (United States of America)"? Actually earlier: "Work Shift Days (United States of America)" appears in header: "Facility Hoke Hospital Location Raeford, North Carolina Department PFS Financial Clearance Job Family Clerical Work Shift Days (United States of America)". That seems to indicate shift days but not specific. Also later: "May be required to periodically rotate shifts and regular days off". Also "All system employees must have the flexibility to meet the department hours of operation". That's schedule info but not specific times. Might be considered schedule content. However we should not create a Schedule section if it's vague like "May be required to periodically rotate shifts and regular days off". That's still specific content about shift flexibility. It's not placeholder like "TBD". It says may be required to periodically rotate shifts and regular days off. That's substantive. So we could include a Schedule section with that info.
Pay: No mention of salary, pay, compensation. So we should not create Pay section.
Benefits: No mention of benefits. So not include Benefits.
Now we need to decide which headings to use: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule.
We have content for About the role (summary). Responsibilities (major job functions). Requirements (maybe education and experience). Qualifications (maybe certifications?). Skills (knowledge, skills, abilities). Schedule (shift flexibility). We'll not include Benefits or Pay.
We must not repeat job title as heading. Good.
We need to output only HTML fragment, no /, no markdown fences.
We'll produce something like:
About the role
...summary...
Responsibilities
- ... ...
Requirements
...education and experience...
Qualifications
...certifications...
Skills
- ... ...
Schedule
...shift flexibility...
We need to preserve all substantive information. Must not invent or summarize away detail. So we need to include all details from each section. Let's extract details precisely. About the role (Summary) text: "Receives accounts and/or schedules for review and work-up regarding preadmission, admission, or add-on procedures, and services. Interviews patients for necessary account follow-up, to obtain accurate and detailed demographic, and financial information. Verifies insurance information, benefits, and initiates medical certification; reviews medical necessity, and assures that authorization is noted on file with supporting reference for the appropriate procedure, service, and/or patient status. Receives, reviews, and completes necessary follow-up for encounter denials. Notifies patients of financial responsibility; explains and reviews insurance coverage, and collects patient’s responsibility via phone, or at time of service, to include initiation of payment arrangements if needed, or as required." We'll keep that as a paragraph. Responsibilities (Major Job Functions) list: We need to parse each bullet. The text after "Major Job Functions The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:" then a colon and then a long string with periods separating items. We need to split into list items. Let's extract each item: 1. Contacts and interviews patients, responsible parties and insurance companies regarding hospital or ambulatory service to secure insurance benefits. 2. Performs insurance eligibility/benefit verification, utilizing a variety of mechanisms (EDI transactions, web access and by calling payers) and documenting information within the appropriate registration system, supporting with reference number. 3. Determines the need for appropriate service authorizations (pre-certifications, 3rd party authorizations, referrals) and contacts the payer, physician and/or case management/utilization review personnel, as necessary. Ensure authorization matches test(s) ordered 4. Pre-registers the patient for upcoming visit(s) including validating/obtaining and entering demographic, financial, and insurance information. 5. Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. 6. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s). 7. Informs patient/guarantor of their liabilities and collects appropriate patient co-payments, co-insurances, deductibles, deposits and outstanding balances at the point of pre-registration. 8. Calculates patient liabilities and provides financial education, referring the patient to resource counseling, as required. Documents payments/actions in the patient accounting system and provides the patient with a payment receipt. Assists patient with payment arrangements as needed for remaining balance. 9. Properly screens appropriate patients for market insurance. 10. Obtains signed physician orders for scheduled tests and procedures from physicians/offices for testing and procedures, and scans into electronic record. 11. Completes appropriate follow-up on insurance denials and initiates appeal, retro-authorization, etc. as needed. 12. Assists insurance companies, physician, and physician practices, and or hospital departments with patient information in accordance with HIPAA guidelines. 13. Meets or exceeds accuracy standard goal determined by Patient Access Leadership; Ensures integrity of patient accounts by working error reports daily, entering accurate data, and documenting all attempts made to collect and or obtain missing documentation. 14. Other duties as assigned We'll keep these as