Clinical Financial Counselor (Oral Pathology)

Classification Title:

Clinical Financial Counselor

Classification 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.

Job Description:

The Department of Oral and Maxillofacial and Diagnostic Science, Division of Oral Pathology, is recruiting for a Clinical Financial Counselor to provide support with the accurate billing of Pathology procedures internally and externally, create and maintain the master database for PECOS, ensure the accurate billing of Radiology external CT scans, ensure the posting of charges for procedures and the billing of all claims for Oral Medicine Clinic and conducting effective accounts receivable follow-up. This position reports directly to the Manager of Operations.

Pathology

• Ensure the accurate billing of Pathology procedures internally and externally.
• Contact pathology patients daily to obtain a copy of the patient’s insurance card and complete all forms required by third-party billing.
• Enter daily pathology charges.
• Input insurance information into the computer system to ensure correct billing for treatment provided.
• Use an organized system for tracking and managing insurance claims and to do EOB follow-up.
• Review accounts receivable for the Pathology Department and perform follow-up on delinquent accounts, according to established policies and procedures, including but not limited to: addressing outstanding receivables, review accuracy of payers, assist patients with payment options and send collections list to Business Office.
• Keep all documentation relating to insurance and financial responsibility until all balances are charged and paid in full in accordance with state, federal and agency guidelines.
• Create and maintain master database for PECOS (providers denied as not ordering and referring providers by Medicare). Collate report for denied providers weekly.
• Verify personal NPI’s through NPPES and submit letters to new denied providers from weekly report. Follow-up with providers’ office on status of credentialing via emails and phone calls. Track status of credentialing of providers in CMS.Data.gov after receiving submission confirmation. Provide necessary educational information on credentialing through the Part D Enrollment portal.
• Assist and provide one on one live support and answering questions on the Part D Enrollment portal. Re-bill claims from credentialed providers within the timely filing limit and with the provider’s effective dates. Provide and facilitate information to CMS and First Coast Options (MAC) as needed.
• Assist medical transcriptionists with tops as needed to ensure continuous workflow.
• Answer calls from Pathology’s external providers.

Radiology

• Collect payments over the phone. Reconcile external accounts and keep current. Ensure the accurate billing of internal Radiology procedures for FORS/OMFS and Implant Center clinics.
• Reconciliation of radiology requests with missing charges reports and daily sign-in sheets. Maintain Radiology accounting databases as needed.
• Ensure timely insurance verification of patients. Monitor the seeking authorization for all procedures. Communicate with various insurance companies which require pre-determination of benefits for comprehensive treatment or when required by a specific insurance carrier.
• Review and instruct correction of all incorrect patient demographics. Ensure accuracy of all appropriate ICD-10 codes and CPT codes for procedures.
• Research, review and correct both unpaid self-pay and insurance claims. Re-submit secondary claims to secondary payers.

Oral Medicine

• Ensure the posting of charges for procedures and the billing of all claims for Oral Medicine.
• Assist with obtaining authorization for procedures and input insurance information into the computer system to insure correct billing for treatment provided.
• Use an organized system for tracking and managing insurance claims and to do EOB follow-up. Review accounts receivable for the Oral Department and perform follow-up on delinquent accounts, according to established policies and procedures.

Expected Salary:

$16.76 - $20.00 per hour; commensurate with education and experience

Benefits:

The University of Florida offers low-cost State Health plans, a number of Dental plans to fit you and your family’s needs, and Vision. Domestic partner coverage through GatorCare is also available. Optional plans such as life, disability, legal and accident insurance are also available.

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