Financial Counselor, Pre-Collect and Price Estimate

Position Summary

This position ensures all insurance and pre-collection requirements are met prior to patient's surgical and/or office procedures and informs patients of their financial responsibility. Responsibilities include communicating patient financial liability, establishing payment plans, and processing delinquent patient accounts.

Responsibilities/Accountabilities

• Pre-Collect and Good Faith Estimates:
  • Communicate with patients, face-to-face or by telephone, collecting on patient financial liability in advance of medical services being performed.
  • Review and verify insurance benefits for all proposed or scheduled procedures.
  • Review and verify insurance eligibility for scheduled patients.
  • Review patient account ledgers and contact patients to initiate pre-collection procedure.
  • Calculate and collect payments appropriately for all patients.
  • Perform price estimates for medical services using price estimate technology and insurance company portals to obtain procedure claim estimates and calculate patient responsibility.
  • Accurately complete good faith estimates in the required timeframes.
  • Communicate with patients in a compliant and professional manner.
  • Establish down payment and payment plan requirements prior to clinic staff scheduling all elective procedures.
  • Complete pre-collection on accounts promptly and efficiently to reduce patient receivables and bad debt.
  • Perform duties necessary to ensure all accounts are processed accurately and efficiently.
  • Perform other duties as assigned by the Supervisor.
• Collections:
  • Communicate with patients, face-to-face or by telephone, collecting on patient financial liability.
  • Process patient accounts promptly and efficiently to reduce receivables and bad debts.
  • Maintain payment plans for adherence to defined payment plan guidelines.
  • Review patient account ledgers and contact responsible parties to collect monies on delinquent accounts.
  • Participate in automated telephone work queue collecting on past due balances.
  • Place delinquent accounts with collection agency.
  • Consult with patients regarding their financial responsibility, current benefits, and limitations on coverage for their plan product and payment options.
  • Review and process bankruptcy paperwork.
  • Review and process deceased patient accounts.
  • Performs other duties as assigned by the supervisor.
• Customer Service and Communications:
  • Communicate with patients, insurance carriers, and other outside entities in a professional manner.
  • Identify solutions and respond professionally to patient concerns, e.g., pleasant tone of voice, courteous language, etc.
  • Use appropriate grammar and demonstrate tact and diplomacy in patient interactions, by phone and in person.
  • Diffuse negative situations with patients and maintain a pleasant and professional tone during stressful circumstances and heavy workload.
  • Communicate with staff members in a professional, pleasant manner; Share information relevant to work, no gossiping or disparaging remarks, accept work without complaint or provide reasons why assignment is unmanageable, ask and answer questions related to improving department performance.
• Teamwork:
  • Work cooperatively with coworkers, providers, and management.
  • Share knowledge and insights with co-workers in a constructive manner.
  • Voluntarily provide coverage to department, staying beyond scheduled ending time when clinic schedule demands it, volunteer to cover time off or unexpected absences, maintain workflow in department without direct supervision.
  • Address conflicts with person directly before involving manager or uninvolved peers.
  • Be considerate of others with regard to taking breaks or meal periods, use of computer and telephone, and noise in department.

Policies and Procedures

• Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and policies and procedures documents.
• Provides assistance and support to leadership in implementing policies and procedures as necessary.
• Actively participates in training, and conducts day to day work activity by adhering to all policies and procedures as enumerated in compliance and risk management programs.

Education, Experience, and Certification/Licensure

• High school diploma/GED required and some post-secondary education is preferred.
• This position requires a minimum of 2 years of previous medical billing/collections experience in a medical office or insurance payer setting.
• Experience in healthcare patient accounting or revenue cycle department, including knowledge of insurance deductibles, co-insurance, and price estimate processes is also required.
• Previous experience working in an electronic medical record system is essential.