Financial Counselor/Pre-Certification Specialist

4 days ago

Kingston, Rhode Island, United States McPherson Hospital Full time
Job Title: Financial Counselor/Pre-Certification Clerk

McPherson Hospital is seeking a highly skilled and detail-oriented Financial Counselor/Pre-Certification Clerk to join our team. As a key member of our Patient Financial Services department, you will play a critical role in ensuring timely and accurate billing, as well as providing exceptional customer service to patients and payers.

Responsibilities:
  • Screen patient accounts and process referrals, assessing and identifying patient financial needs through interviews and/or phone calls.
  • Collect necessary documentation for financial assistance and assist patients as needed to complete applications.
  • Identify patient accounts requiring adjustment and communicate with PFS Supervisor.
  • Provide estimates to patients and/or hospital personnel as requested.
  • Provide exceptional customer service to patients and payers by responding to inquiries received via phone, email, or in-person.
  • Process patient payments and establish payment plans.
  • Review weekly and/or monthly reports from collections agencies.
  • Contact patients to obtain updated information to ensure timely and accurate billing.
  • Verify insurance information through payer contacts via telephone, online resources, or electronic verification systems.
  • Identify payer authorization/referral requirements and work with physician offices and insurance carriers to obtain prior authorizations.
  • Provide appropriate documentation and follow-up to patients, physician offices, case management/utilization review, and payers regarding authorization/referral deficiencies.
  • Work with surgical, clinic, and other teams to coordinate timely patient care.
  • Identify private-pay and/or underinsured patients and refer account(s) to Patient Financial Service Representative.
  • Maintain up-to-date information on various insurance companies and any relevant changes; communicate changes to team.
  • Exercise ethical and sound judgment to complete all tasks in a timely manner.
Requirements:
  • High school diploma or equivalent.
  • 2+ years of experience in a hospital or medical clinic setting preferred.
  • High level of literacy with personal computers, including prior experience importing and exporting data files.
  • Entry-level skills in Microsoft Office, including Excel, Outlook, and Word.
  • Excellent interpersonal skills demonstrated through interactions within teams, staff, and management.
  • Ability to work in a changing environment and be able to change duties at a moment's notice.
  • High level of accountability, willingness to learn, and enthusiasm.
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload.
  • Detail-oriented with above-average organizational skills.
  • Plans and prioritizes to meet deadlines.
  • PC skills required to become proficient in the use of a variety of computer-based systems.
  • Exceptional follow-through and job execution skills – obtaining authorizations timely and following accounts through payment.
  • Must be familiar with office equipment typically found in a business office environment.
  • Basic knowledge of medical terminology.

We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability, status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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