Financial Counselor

Job Title:  Financial Counselor

Department:  Business Operations

Reports To:  Business Operations Manager

FLSA Status:  Non-exempt (hourly)

Work Schedule:  Monday-Friday, 8:00 A.M. - 5:00 P.M.

Summary:  The Financial Counselor is responsible for analyzing account data and upcoming appointment data to provide effective counseling to patients while ensuring that the practice receives adequate payment for services rendered.  Job duties must be completed in line with the practice's core values of Excellence, Innovation, Collaboration, Advancement, Stewardship, and Patient Centered Care.

Essential Duties and Responsibilities:  

Quality and Customer Focus:

Explain bills and provide assistance to patients

Explain OEI financial policy to patients and staff

Answer patient calls and requests promptly and efficiently.  Return all messages withing 24 hours

Provides patient services utilizing excellent customer service skills

Counsel patients about their insurance coverage and benefits, including deductible, copay, coinsurance and estimated out of pocket costs

Meet with patients/guarantor to discuss their out-of-pocket costs for their recommended treatments and determine payment plans and other financial accommodations to pay for those treatments

Contact insurance carriers or other sources and act as an advocate for the patient

Document payer requirements for services on patient's accounts

Consistently document all conversations and discussions with payer, patient, provider, and other OEI staff on patients' accounts in practice management system.

Financial Management:

Update the billing system to reflect the insurance status of the patient

Analyze insurance coverage and benefits for services to ensure timely claim filing

Facilitate payment sources for uninsured patients and assist with any financing or third-party applications

Issue financial clearance for treatment of patients

Prepare, print and mail collection letters to patients

Calculate amounts due according to credit and collection policies

Collect cash payments appropriately for all patients

Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage

Examine insurance policies and other third-party sponsorship materials for sources of payment

Determine if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment

Assist insurance team to resolve insurance claim rejections/denials and remedy expediently

Review practice management reports to make referrals for financial counseling

Inform attending physician of patient financial hardship

Calculate and collect patient out-of-pocket expenses for scheduled surgical services.

Maintain collection records for monthly reports to share with management.

Job Knowledge, Organizational and Operational Skills

Communicates with front office staff, clinical staff, and patient accounting regarding scheduling, patient treatment and financial counseling needs

Maintain current knowledge regarding payer policies and procedures

Perform those duties necessary to ensure all accounts are processed accurately and efficiently

Gather necessary documentation to support proper handling of inquiries and complaints

Properly document all account activity in Electronic Medical Record systems

Set up, maintain and edit payment arrangements in the practice management system on account when established 

Admit, register, and pre-register patient with accurate patient demographic and financial data

Required Behaviors:

Excellent written and verbal communication skills required

Ability to prioritize tasks and work independently 

Must be highly organized to successfully manage multiple tasks simultaneously 

Must demonstrate professionalism through appearance and extensive interactions with others

Exhibit pleasant, professional telephone etiquette at all times

Education and/or Experience:

High School diploma or GED required

Knowledge of medical billing requirements, third part payers, coordination of benefits, scheduling practices and provider template management required

Minimum of two years of medical office experience preferred, preferably in an insurance or collections position

Knowledge of managed care referral and prior authorization requirements

Experience in maintaining confidentiality in dealing with sensitive issues

Physical Demands:

Extended periods of sitting, keyboarding, and talking on the telephone

Occasional lifting and/or moving up to 10 pounds

Extended periods of standing