PFS Financial Counselor

About the role

PFS Financial Counselor at Tidelands Health is responsible for performing administrative duties related to the fiscal needs of patients. This includes reviewing insurance processing for accuracy, patient statements for appropriate payments and adjustments, and handling financial assistance and billing record requests.

Responsibilities

• Qualify patients for financial assistance
• Facilitate financial clearance for patients
• Utilize appropriate means to communicate with customers
• Document activities in Meditech, Quadax, eCW, Charity Guide or Verge
• Maintain progress of financial assistance applications
• Validate insurance billing and processing
• Resolve insurance processing issues
• Work with various Tidelands Health vendors to resolve customer inquiries
• Assist with Patient Payment Portal Enrollment
• Report repetitive issues to Assistant Director of PFS
• Complete cross training in all Tidelands Health PFS-ASC locations

Requirements

• High School Diploma with a minimum of five years healthcare experience
• Associate's Degree in a business-related field and a minimum of three years healthcare experience preferred
• Two (2) or more years of experience in patient financial counseling, patient customer service, scheduling, or prior authorization
• Two (2) or more years of experience and/or knowledge of third-party payor regulations related to managed care, denials, and reimbursement issues

Skills and Abilities

• Negotiate point of service payment
• Review and explain insurance processing per explanation of benefits when necessary
• Rebill insurance claims when necessary
• Demonstrate exemplary core customer skills
• Make independent decisions
• Show collaborative abilities
• Manage time and organize tasks
• Understand third-party payor regulations related to managed care, denials, and reimbursement issues
• Know terminology for hospital or physician billing
• Interpret and follow detailed policies and workflows
• Understand CPT and ICD-10 coding

Physical Demand

The job requires light physical demand, including standing, walking, and occasional lifting.