Financial Counselor

4 months ago

Connelly Springs, United States EmergeOrtho Full time
Description

Position: Financial Counselor

Status: Full Time

Hours: Monday-Friday 8:00am-5:00pm (1hour lunch)

Location: Valdese, NC

Date Posted: July 28, 2021

Job Description:

The Financial Counselor will ensure that all processes related to insurance eligibility and verification are performed prior to patient's procedure and inform the patients of their financial liability prior to the procedure date as a service to patients of the practice in accordance with the member(s) insurance policy requirements. Responsible for setting up payment arrangements according to the current COS policy. Screens patients for eligibility to participate in government funding programs. Responsible to meet with those patients currently owing a balance in an effort to collect any past due monies. Responsible for and obtaining insurance eligibility, benefits and prior authorization for office visits, surgeries, diagnostic testing and procedures. Scheduling procedures and follow up visits. Reviewing daily patient profiles for upcoming appointments with detailed patient account review.

Essential Duties & Responsibilities:

1. Verify patient demographic information for accuracy and update company financial records accordingly.

2. Meet with patients to explain cost of treatment, Insurance coverage and patient financial responsibility.

3. Coordinate proper insurance certification information/documentation of patient's insurance to be used to estimate patient financial responsibility

4. Develop a standard estimate that includes CPT codes and standard units based on normal course of treatment for the particular procedure to be performed.

5. Responsible for monitoring and collecting preoperative deposits owed.

6. Review all payment/financial options. (Vocational Rehab, Medicaid, Payment Plans, etc.)

7. Develop an estimate that can be forwarded to the front desk detailing the amount of money needing to be collected.

8. Review schedules on a daily basis and coordinate with front desk to meet with those patients owing a prior balance to collect or make payment arrangements.

9. Scan budgets into patient chart/profiles.

10. Report collection of monies to the Billing Director and Practice Manager.

11. Obtains eligibility, benefits and prior authorization for office visits, surgical procedures, diagnostic tests, office procedures and DME.

12. Scheduling COS and outside facility procedures.

13. Documents all correspondence within the practice management system.

14. Provides authorization information to the clinical staff and hospitals as needed.

15. Prepare patient profiles for upcoming appointments reviewing account for billing, payment and authorization status, global period and payment due at appointment.

16. In general, act and perform as a leader to deliver these essential duties and responsibilities as a valued service to all patients. In accordance with Financial Policies and Procedures, no surgical procedure should be scheduled until all financial details are completed in accordance with member(s) insurance policy.

17. All other duties as assigned.

Requirements

Education, Training, & Experience:

High School Diploma or GED required

Two (2) or more years experience with medical insurance

Required Skills

1. Basic accounting and medical terminology to include ICD9, ICD10 and CPT coding.

2. Ability to analyze insurance coverage and benefits in order to inform patients of their coverage.

3. Excellent oral and written communication skills.

4. Detail oriented with good organizational skills.

5. Must be able to develop and maintain professional, service oriented working relationships with patients, physicians, co-workers and supervisors.

6. Must be able to understand and comply with Carolina Orthopaedic Specialists, PA policies and procedures.

7. Must maintain a positive attitude and be willing to work in a team oriented environment.

8. Ability to read and interpret medical records to determine what is appropriate to obtain authorization.

9. Ability to work effectively with patients and employees.

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