Financial Counselor

2 weeks ago


Memphis, Tennessee, United States Baptist Memorial Full time

Position Overview

The Financial Counselor plays a crucial role in ensuring that patients receiving chemotherapy and other specialized treatments have their services meet medical necessity and appropriateness according to insurance guidelines and regulations. This position is responsible for initiating and coordinating pre-certifications and prior authorizations in alignment with payer policies before services are provided.

Key Responsibilities

  • Review treatment plans to verify medical necessity in accordance with insurance policies and guidelines.
  • Conduct research on insurance company policies and medical literature to assess eligibility for services.
  • Analyze patient medical records to gather essential information for pre-certification processes.
  • Track and manage authorizations from various insurance carriers efficiently.
  • Engage with new patients to educate them about their insurance benefits and anticipated out-of-pocket costs prior to treatment.
  • Assist patients and their families in collecting deductibles and co-pays, and facilitate the establishment of payment plans.
  • Gather necessary consent forms and financial documentation to initiate applications for assistance programs.
  • Support self-pay patients in applying for financial assistance programs.
  • Collaborate closely with healthcare providers and clinic staff to ensure positive patient outcomes and timely treatment delivery.
  • Maintain compliance with regulatory requirements and communicate necessary guidelines to relevant staff.

Qualifications

Education: Preferred: Associate's degree or completion of two years of college coursework. Minimum: Strong communication skills in English, both written and verbal, with the ability to document information accurately.

Experience: Preferred: Five years of experience in a healthcare setting, with a focus on front-end collections. Minimum: Three years of office experience, including at least one year in a healthcare-related role.

Licensure and Certification: Preferred: CHAA certification.

Special Skills: Preferred: Familiarity with oncology pre-certification guidelines. Minimum: Ability to interpret medical policies and guidelines, strong multitasking capabilities, basic computer proficiency, and problem-solving skills, especially in high-pressure situations.

About Baptist Memorial Health Care

Baptist Memorial Health Care values the expertise and compassion of its staff. The organization is committed to providing competitive compensation and benefits, recognizing the hard work of its employees. Baptist has been acknowledged for its exceptional benefits packages, ensuring a supportive work environment.


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