FINANCIAL CARE COUNSELOR

Friday-Sunday 7:00a m-7:30pm WEO Shift differential

Occu pationalSummary

• A ccurately complete patient accounts based on departmental protocol, policies and procedures, and compliancewith regulatory agencies, to include but not limited to pre-admission,admission, pre-registration and registration functions.
• Ensure all insu rance requirements are met prior to patients' arrival and inform pat ients of their financial liability priortoarrival for services.</ li>
• Arrange payment optionswith the patients and screens pa tients for government funding sources.
   
  Work Perf ormed

• Analyze insurance coverage and benefits for service to ensure timely.
• Obtain authorizations based payment. on insurance plan contracts and guidelines .
• Documentbilling system.
• Ex plain bills provides assistanceto visitors and patients.
• Explain policies anddepartmental coverage as requested.</spa n>
• Calculateandaccording toPRMO credit and collection po licies.
• Implement appropriate collect cash pay ments appropriately forall patients.
• Reconcile daily necessity of third partysponsorship and process patients in a ccordance reimbursement.
• Obtain all Prior Auth orization Certification and/orauthorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Determine ifpatient's conditionis the result of an acci dent and perform completeresearch to determine the appropriate source of liability/payment.
• Admit, register and pre-reg ister patients withaccurate patient demographic and financial data.< /span>
• Resolveinsurance claim rejections/denials and reme dyexpediently. 
• Evaluate diagnoses to ensure complia nce with the Local Mcessary toensure all accounts are processed accurate lyandefficiently.
• Perform those duties ne/span>
• Compile departmentalstatistics for budgetaryand reporting purpos es.
• collection actions andassist financially r esponsible persons inarranging payment.
• Make re ferral forfinancialcounseling.
• Determine with policy and procedure.
• Examine insurance polici es and other thirdparty sponsorship materials forsources of payment.
• Informattending physicianof patient financial har dship.
• Complete the managed care waiver form f or patients considered outof network and receiving services at a red uced benefit level.
• Update the billing system to reflect the insurance status of the patient.
• Re fer patients to theManufacturer Drug program as needed for medicatio ns.
• Greet and procedures, and resolves problem s.
• Gathers necessarydocumentation to support p roperhandling of inquiriesand complaints.
• Assi st with according topolicy and procedure.
• Ente rand update referrals as required.
• Communicate with insurance carriersregarding clinicalinformation requested and tores olve issues relating to coverage
   
  Knowledge,Skills an d Abilities

• Excelle nt communication skills, oral and written.
• Abi lity toanalyze relationships with patients, physicians, co-workersand supervisors. data, perform multiple tasks and work independently.</spa n>
• Must be abletodevelopand maintain professional,service -oriented working, 
• Must be able to understand and comply with policies and procedures.
   
  Level Character istics

• Position responsible forhigh pr oduction generated accurately in accordance with establishedbusiness processes or regulation.

Requiresworking knowl edge of compliance principles. Job allows the opportunity to workindepen dently.
 

Excellent commu nication skills, oral and written. Ability to analyze data,perform multi ple tasks and work independently. Must be able to develop andmaintain pr ofessional,service-oriented working relationships with patients, physici ans, co-workers and supervisors.Must be able to understandand comply wit h policies and procedures.

Po sition responsible forhigh production generated accuratelyin accordance with established business processes or regulation. Requiresworking knowl edge of compliance principles.Job allows the opportunityto work independ ently.