Job Summary: The Patient Financial Counselor educates and assists patients with making informed decisions about payment options and financial arrangements regarding their medical bills. Serves as the liaison between patients and their insurance companies to coordinate payments and answers questions from both parties. This position is responsible for obtaining waivers, providing accurate documentation in patients chart, provide estimates and the collection of monies, including private pays, out of network insurance policies in full, deductibles, out of pockets and past due balances from the patient. This job requires good communication skills and the ability to comprehend insurance policies for explanation to patients.
Major Job Responsibilities/Essential Functions:
Provide information to patients on costs, payment methods and alternatives to payments/financial assistance. Provide estimates for patients with out of network policies & self-pay and collect in full.Provide estimates upon request.Obtaining signed waivers prior to patient receiving services. Assist patients to navigate through various facilities and provider bills.Provide answers to reimbursement questions regarding health plan eligibility, benefit issues, co-pay requirements and medical referral requirements. Monitor and collect the financial responsibilities of patients seeking financial counseling. Prepare estimates of consultations, procedures, and all services. Calculates payments, and informs patient of acceptable arrangements on balance, both current and previous. Negotiate and strategize patient payment arrangements.Establish contract and payment plan with self-pay patients.Appropriately document and report payment information, update patient account and balances. Must document diligently in patients account with regards to all communication with the patient, insurance, clinical teams, etc. Maintains confidentiality of all medical, financial, or other sensitive materials and information in printed, electronic or verbal form which may jeopardize the privacy of patients.Demonstrate knowledge and compliance with the Health Information Portability and Accountability Act (HIPAA) and HHS ordinances.Comply with current rules, regulations, policies and procedures. Other duties as assigned.Knowledge, Experience, and Skill Requirements:
Bachelor’s degree in healthcare or business preferred.Comprehensive understanding of accounts receivable management in a healthcare setting required.Excellent understanding of medical terminology and orthopedic coding. Ability to make independent decisions and exercise discretion when working with patients and insurance companies. Excellent analytical and problem-solving skills.Excellent organization, communication (both written & verbal) and interpersonal skills required.Typical Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Requires sitting, standing and walking for certain periods of time and traveling between Steadman Clinic facilities.Requires normal visual acuity and hearing.Typical Working Conditions: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Typical clinic environment.Requires working under stressful conditions on occasion. Works with a variety of highly confidential, sensitive material.