Clinical Financial Counselor

Classification Title:

Clinical Financial Counselor

Job Description:

This position is in the College of Public Health and Health Professions, Department of Clinical & Health Psychology and will be physically located in the Psychology Specialties Clinic, housed in UF Health Science Center. The incumbent will initiate and coordinate pre-certification and prior authorization for patients with their insurance carrier, provide financial counseling to patients, and ensure timely claim and account follow up. The incumbent must have applicable knowledge of ICD-10-CM, CPT coding, and a working background in third party reimbursement and managed care contracts. Incumbent must possess the ability to interact tactfully with patients while pursuing appropriate collections in an extremely busy work environment. This position will report to the Manager, Clinical Services Representatives.

Job Duties:

Patient Financial Assessment

• Interact with patients via face-to-face, telephone or written communication to determine financial status and insurance coverage.

Insurance Verification and Authorization

• Verify patient health insurance policies and obtain prior authorizations in advance of patient appointments.
• Review the clinic patient schedule daily to ensure insurance verifications and identify visits requiring prior authorization have been obtained.
• Assess delinquent accounts and discrepancies in third-party information systems, initiating follow-ups as needed.
• Handle patient inquiries regarding account statements and insurance policies.
• Coordinate with patients, physicians, insurance companies, and hospitals during the pre-certification process, including second opinions and referrals.
• Manage telephone communications with patients and insurance representatives regarding pre-certification and additional information requests.

Claims Management

• Follow up with UF Health Billing and Accounts Receivables (B/AR), providing necessary documentation to ensure claim resolution.
• Interpret third-party explanations of benefits to resolve issues and assist in settling claims for patients.
• Review provider schedules and patient accounts for outstanding claims, collaborating with UF Health Billing and Accounts Receivables (B/AR) as needed.

Insurance Knowledge and Communication

• Stay knowledgeable about contracted insurance plans, regularly reviewing policies to understand deductibles, co-payments, and coverage limits.
• Address inquiries from internal and external referring physician offices regarding insurance guidelines and the authorization process specific to behavioral health.

Clinic coverage

• Assist with patient scheduling and front desk receptionist coverage when needed.
• Other duties as assigned.

Expected Salary:

$18.05 - $19.65 per hour, commensurate with education and experience.

The University of Florida (UF) offers an exceptional benefits package, including health, dental and vision insurance; state retirement plans; a generous leave program; and tuition assistance. UF is a Public Service Loan Forgiveness (PSLF) eligible employer. For more information on benefits, please visit UF HR Benefits and Rewards at https://benefits.hr.ufl.edu/.

 

Minimum Requirements:

High school diploma or equivalent and one year of related experience and/or training, including customer service; or an equivalent combination of education and experience.

Preferred Qualifications:

• Excellent computer skills. Knowledge and experience with MS Word and MS Excel. Experience with medical software systems such as EPIC.
• Applicable knowledge of ICD-10-CM and CPT coding and a working background in third party reimbursement and managed care contracts. Familiarity with psychology coding, billing, patient privacy laws.
• Certified as a medical biller or medical coder.
• Ability to communicate professionally, both orally and in writing, with medical professionals, clinical office staff and a varied patient population.
• Knowledge of techniques for written and verbal communications including standard business formats.  This includes the ability to compose routine correspondence including editing for grammar and spelling.
• Ability to exercise good judgment and maintain a professional demeanor.
• General working knowledge of medical office procedures.
• Ability to maintain appropriate confidentiality and patient privacy.
• Strong organizational and multi-tasking skills.

Special Instructions to Applicants:

In order to be considered, you must upload your cover letter, resume, and a list of three references.

This position is time-limited.

This position is eligible for veteran's preference. If you are claim