Summit, New Jersey
Posted: 10-Jan-25
Location: Grapevine, Texas
Categories:
Internal Number: 25000470
JOB SUMMARY
The Financial Counselor is responsible for performing financial clearance functions, including but not limited to, verifying insurance eligibility and benefits, ensuring authorizations and providing price estimates. This position facilitates resolution in disputed billing issues which require intense interaction with patients. This position also serves as subject matter expert in financial assistance policies, facility point of service collections and provides support on special projects.
ESSENTIAL FUNCTIONS OF THE ROLE
Works closely with facility leadership to ensure all patients are financially cleared and screened.
Conducts patient interviews to obtain demographic and financial data for registration, insurance verification, pre-certification and billing.
Records accurate patient demographic information when reviewing previous accounts and accounts with future dates of service.
Follows and acts on several complex system policies (financial assistance, limited plan, point of service, out of network, etc.)
Obtains and screens guarantor financial information for financial assistance and or refers patient to appropriate resource for public assistance programs.
Provides estimates of procedures and services, calculates payment requirements, and negotiates pre-service payments according to financial clearance requirements.
Establishes payment arrangements for future and previous services.
Reviews future schedule to ensure pre-authorization and pre-payments have been collected.
Assists with contacting physician office and patient in order to ensure pre-authorization and referral requirements are met prior to the date of service.
Reviews and interprets explanation of benefits received from payers in order to assist patients and guarantors with understanding of claims processing or denial of services by payer.
KEY SUCCESS FACTORS
3 years of healthcare experience or education equivalency required. Proven ability to problem-solve, perform critical thinking.
Requires good listening, interpersonal and communication skills, and professional, pleasant and respectful telephone etiquette.
Ability to maintain a professional demeanor in a highly stressful and emotional environment, to include crime, behavioral health and suffering patients in addition to life or death situations.
Must be able to exhibit a high level of empathy with the ability to effectively communicate with patients and family members during traumatic events, while demonstrating exceptional customer service skills.
Demonstrates ability to manage multiple, changing priorities in an effective and organized manner.
Excellent data entry, numeric, typing and computer navigational skills. Basic computer skills and Microsoft Office and Excel.
BENEFITS
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
QUALIFICATIONS
- EDUCATION - H.S. Diploma/GED Equivalent
- EXPERIENCE - 3 Years of Experience