Financial Counselor - Pre Authorization

Position Summary

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities.

Responsibilities

• Understands the importance Orlando Health places on providing exemplary customer service and performs job functions in a manner that helps meet the department customer service goals.
• Demonstrates a positive and professional approach and communicates effectively with customers and team members at all times.
• Efficiently and accurately gathers and inputs patient/guarantor demographic and financial information.
• Contacts Primary Care or Admitting Physician to obtain authorizations, diagnosis, and procedure detail as necessary.
• Explains necessary forms and obtains signatures from patient/guarantor.
• Contacts appropriate payers, verifying benefits and obtaining necessary authorizations.
• Explains insurance benefits and collects co-pays, deductibles and self-pay portions due.
• Collections for related professional care when appropriate.
• Documents authorization and benefit information in registration system.
• Assembles patient record and obtains copies of relevant documents including insurance cards, photo identification cards and any advance directives.
• Exhibits competency in the use of all registration systems, electronic verification tools and Web based resources.
• Follows Patient Financial Services self-pay policies including completion of Guarantor Financial Statement Application, explanation of payment options and collections of monies due.
• Follows Patient Financial Services policies related to cash handling.
• Performs basic individual cashiering functions.
• Collections and inventories patient valuables following policy guidelines.
• Maintains basic understanding of the medical necessity screening process and appropriate systems.
• Performs appropriate pre-registration functions including calling physician offices, insurance payers and the patient/guarantor, as necessary.
• Maintains departmental logs for statistical reporting.
• Consistently meets Quality Assurance standards set by Patient Access and the department.
• Maintains flexibility in work schedule availability that allows department to change/modify work schedule to meet departmental needs.
• Maintains compliance with all Orlando Health policies and procedures.
• Attends and participates in department staff meetings and attends other meetings as assigned.
• Responsible for reviewing and adhering to all Patient Financial Services and departmental education initiatives.
• Mets all corporate and Patient Financial Services annual recertification and education requirements.
• Assists his/her manager in planning and organizing department activities.

Qualifications

• Education/Training: High School or equivalent. Must complete Patient Financial Services Orientation program and annual educational requirements.
• Licensure/Certification: None.
• Experience: Two (2) years’ experience in a financial, business office, or customer service environment required. Proficient in Windows Microsoft Office-based products (Word, Excel, PowerPoint). Typing proficiency. One (1) year PC/Windows experience.