Financial Counselor - Patient Financial Service SVHC - FT - Day

Position Status:

Full time

Shift:

First Shift (Days - Less than 12 hours per shift) (United States of America)

Hours per week:

40

Job Information

Exemption Status: Non-Exempt

A Brief Overview
The individual in this role is a key member of the Billing management team in oversight of day-to-day claim analyst activities. The individual in this role is also responsible for the coordination of the Third Party billing system. Under direction, responsible for the processing of patient accounts after initial bill submission to final 3rd party payment resolution. This responsibility includes timely and accurate resolution of denied claims and insurance coordination and follow-up on unpaid claims. This individual is also responsible for tracking and analyzing payment denials from all third party payers, appealing denial decisions to obtain payment, coordinating with clinical departments, retrieve RA's and other required documents requested from payor. Calls or emails made to Drug Companies and patients in regards to claims processing. Review to ensure patient is registered correctly within our system. Responsible for professionally interacting with customers including patients, physicians, and other staff members to thoroughly and promptly research and resolve all inquiries and customer service problems. Track claims for processing. In addition, assists with other duties as assigned.

Education Qualifications

• High School Diploma / GED Required
• Associate's Degree Preferred

Experience Qualifications

• 3 years Experience in a clinical healthcare setting such as physician’s office or hospital relating to patient financial services, patient registration, patient scheduling or related healthcare experience. Related financial experience may also be accepted. Required

Skills and Abilities

• Ability to work independently with strong analytical and problem solving skills utilized to determine work prioritization, coordination, application of departmental procedures, and resolve complex customer service issues. (Required proficiency)
• Ability to define problems, collect data, establish facts, and draw valid conclusions. (Required proficiency)
• Sophisticated customer service skills. (Required proficiency)
• Effectively functions as liaison between team, other team leaders, PFS management, physicians, or other departments within the organization. (Required proficiency)
• Determines priority of daily processing work and effectively completes work as assigned. (Required proficiency)
• Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or government regulations. (Preferred proficiency)

What you will do

• Ensures customer concerns are processed in compliance with organization’s policies while maintaining the highest level of patient and employee rights, including confidentiality of patient information and personnel issues.
• Ensures necessary data, identified processing issues and related information is provided to departmental management, appropriate departments and individuals within the organization in a timely manner.
• Demonstrates a good working knowledge of all applicable processes within PFS to include, patients correctly registered, denials management, claims processing, and payment recovery.
• Process bankruptcies within Epic system.
• Researches and accurately resolves unpaid insurance accounts (primary and secondary) via internet, e-mail, direct calls, eligibility system, etc. utilizing system worklists or system reports.
• Thoroughly researches and resolves identified payment discrepancies in a timely manner including identifying and correcting posting errors (i.e. money applied to wrong account).
• Promptly follows up with appropriate parties to effectively resolve customer questions and problems.
• Complies with all Medicare, Medicaid and other federal health insurance programs rules and regulations. In addition, informs management of any known or suspected violations by other employees or suppliers.
• Develops and maintains departmental records, reports, and statistical data in order to meet both administrative and regulatory requirements.
• Exhibits a positive attitude with a professional and pleasant demeanor when communicating with all customers and providing information.
• Consistently uses diplomacy and respect both in person and when using the telephone, and performs effectively and professionally under stressful conditions.
• Ensures customer concerns are processed in compliance with organization’s policies while maintaining the highest level of patient and employe