Financial Counselor
DEPARTMENT: Business Office SCHEDULE: On-Call; Days Shift; Wednesday, Thursday, Friday, Saturday and Sunday: 10:30AM - 7:00PM.
EDUCATION/LICENSURE/CERTIFICATION: N/A.
QUALIFICATIONS: Experience Required: Previous experience with financial counseling and account resolution preferred with a minimum of one year recent billing experience in a hospital/insurance/or medical office setting.
Knowledge of and usage of medical terminology, ICD-9 and CPT coding required.
Experience with extracting and pertinent information from medical charts required.
Must be able to appropriately use the fee schedule and billing guideline.
Knowledge of Medicare and Medical billing rules preferred.
Resolve patient questions regarding fees and billed services.
Must have excellent interpersonal skills to interact with patients, physicians, medical center staff and others.
Knowledge of community resources helpful.
Must be able to use a variety of computer programs and access specified internet web sites for information.
Able to prioritize works assignments and performs multiple tasks amid frequent interruptions.
Able to work independently.
Evidence of excellent attendance record is required.
Able to work in a Labor/Management Partnership environment.
Contribute positively to team building and morale.
SKILLS TESTING: 35 WPM Typing required; Medical Terminology required; CPT & ICD 9 CODING REQUIRED.
Must pass Test.
DUTIES: Interview non-members and industrial patients presenting to the Emergency Department ( and other areas of the medical center).
Determine method of payment for self-pay non-members and need for financial assistance.
Verify Medicare and MediCal eligibility.
Verify health plan membership.
Verify Medicare and Medical eligibility.
Verify health plan membership.
Verify insurance benefits for patients with commercial insurance.
Audit E&M coding for all billable cases presenting to the ED to ensure coding and documentation compliance.
Consult with physicians when necessary regarding coding and documentation.
Add additional charges to all ARBIS accounts and process all Emergency Department billing within the established time frames.
Maintain a log of all patients and accounts billed.
Review all ED OSCR to ensure completion of required fields.
Track return of incomplete OSCRS.
Must be able to help patients with the Medical Financial Assistance Program.
Interview all non-members admitted to the facility or scheduled for surgery and verify insurance coverage.
Verify COB coverage and maintain the COB database for the facility.
Collect advanced payments when appropriate.
Issue transportation denial letters in the ED. Adhere to regional, business office and medical center policies and procedures.
Perform other duties related to operational needs as assigned my management.
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