Financial Counselor/ Pre-Certification Clerk

Job description

Mission statement

Superior health care and exceptional service for each person, every time.

Vision

To be a vibrant and thriving five-star center for health, serving as our community's first choice for health and wellness.

Our C.A.R.E. Values

• Compassion - I will treat everyone with kindness, acceptance, empathy, and understanding.
• Accountability - I will be trustworthy, responsible, and dependable while taking ownership of my actions.
• Respect - I will value the feelings, wishes, rights, and traditions of everyone without judgment.
• Excellence - I will strive to understand and exceed the expectations of others.

Benefits

Medical Insurance

Dental

Vision

Health Savings Account

Flex Spending Account/Dependent Care Spending Account

Hospital Indemnity

Life Insurance- Employer Paid

Long-Term Disability/ Short-Term Disability-Employer paid

Voluntary Life & AD&D

MASA- Medical Transportation Solutions

403 (b) Retirement Plan- up to 4% employer contribution

Earned Time Off

Exetended Illness Bank-Hospital contribution

Free 24-hour fitness center

Job Title: Financial Counselor/ Pre-Certification Clerk

• Full-time: Days, M-F (8hr shifts)

Job Summary: The Financial Counselor/ Pre-Certification Clerk will work directly with and on behalf of any patient that requires assistance with payment plans, charity applications, insurance and/or any related billing/balance questions, ensuring all patient due balances are paid in full, timely and/or rectified fully through other means all while maintaining a high level of customer service. The Financial Counselor/ Pre-Certification Clerk is also responsible for obtaining authorizations from insurance companies for clinic services along with verifying patient eligibility and benefit information for the specific service to be performed.

Responsibilities

• Screen patient accounts and process referrals, assess and identify 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 to 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 (Medicare, Medicaid, government and commercial) 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.

• Maintains up-to-date information on various insurance companies and any relevant changes; communicates changes to team.

• Exercise ethical and sound judgement to complete all tasks in a timely manner.

• Other duties as necessary.

Education/Experience

• Highschool diploma or equivalent

• 2+ years experience in a hospital or medical clinic setting preferred

Skills

• High level of literacy with personal computers, including prior experience importing & 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 independently and proactively inquire and check-in with manager regarding progress updates. Must be comfortable with a fast paced, free flowing environment with a strong degree of autonomy.

• 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.