Financial Counselor - Pre-Services

Responsibilities

• Ensures that an account is established for every scheduled patient.
• Verifies patients’ insurance coverage, eligibility, and Point of Service financial obligation for all scheduled services, and documents the system in detail.
• Adheres to all third party payer requirements for both government and commercial payers.
• Determines insurance eligibility and coverage, obtains/confirms authorization to avoid non-compliance and penalties to the patient, health system and physician.
• Communicates current Medicare requirements, HIPAA compliance and reimbursement criteria.
• Collaborates with Case Management to ensure patient status is correct and documentation is provided to insurances as needed.
• Creates and/or updates hospital account.
• Obtains and enters into hospital information system required patient demographics and insurance information in a timely manner after procedure is scheduled.
• Documents all information according to departmental guidelines.
• Provides feedback to supervisor on changes/updates implemented by insurances as obtained.
• Contacts patients to verify demographic information and to perform financial counseling prior to time of service.
• Collections patient responsibility due, provides information on payment plans and financial assistance as necessary.
• Follows department and network policies concerning discounts, package rates and basic financial assistance.

Requirements

• High School Diploma or GED Required
• Associates in related healthcare field Preferred
• Experience: 1 year in healthcare field including medical office insurance/front desk, hospital registration, hospital business office (billing or collections) Required or 3 years in healthcare field including medical office insurance/front desk, hospital registration, hospital business office (billing or collections) Preferred