Position: Patient Financial Counselor
Reporting Relationship: Medical Billing Manager
Effective Date: October 1, 2018
The Patient Financial Counselor is responsible for performing day-to-day follow-up with patients for upcoming appointments to determine insurance coverage and patient costs and payment options. Day-to-day activities may include all or some of the essential functions listed below depending upon individual experience / knowledge and the needs of the organization which are subject to change from time to time.
- Utilize the practice management system, payor websites, payor benefit line and fee schedules to verify insurance eligibility, confirm authorization/referral requirements, and determine allowable rates, coinsurance, deductible, and out of pocket expense for estimated patient responsibility associated with procedures and/or surgery. Print routing sheets and document estimated costs in practice management system and on pre-service estimation worksheet.
- Place phone calls to patients in an attempt to obtain pre-payment, establish acceptable payment arrangements and/or to acquire information necessary to receive payment from insurance or other sources on all procedures / surgeries.
- Notify the Billing Supervisor when appropriate financial arrangements per the patient liability policy cannot be made prior to patient being treated for services.
- Adhere to best practices standards in performing day-to-day follow-up tasks. This includes following procedures outlined in the Patient Liability Policies.
- Process credit card transactions, patient receipts, check payments received at TNR.
- Cross-train to help cover Copay Assistance program
- Assist with a variety of projects and performs other duties as assigned.
Education, Training, and Experience
- 1+ years of experience handling physician financial counselor duties or working for Tennessee Retina.
- Prefer candidates that have experience reading and understanding payer eligibility electronic returns. Includes the ability to differentiate between insurance plans, copay, deductible, and coinsurance (patient responsibility).
- Must have experience in speaking with patients regarding the amounts due prior to and post scheduled appointment. Includes negotiating pre-service deposit, copay, deductible and coinsurance amounts.
- Must be able to meet average expectations for productivity and quality standards.
- Requires ability to organize and prioritize day-to-day tasks in order to keep work assignments current.
- Prefer candidates that are proficient in utilizing MS-Excel for analyzing data using basic formulas, pivot tables, and charts.
Maintains strict confidentiality with regarding to protected health information (PHI) and understands and adheres to TNR’s HIPAA privacy and security policies and procedures.
Typical Physical Demands
Position requires prolonged sitting, some bending, stooping, and stretching. Good eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required. Employee must have normal range of hearing and eyesight to record, prepare, and communicate appropriate reports.
Typical Working Conditions
Position functions within a normal office environment. Occasional evening or weekend work may be required in order to fulfill assigned duties as dictated by fluctuations in workload volumes and/or staffing vacancies.
Salary: This is a full-time, hourly position
Please submit resumes to firstname.lastname@example.org.
"Tennessee Retina is great; There are no words to describe the way Patient & Family are treated with the utmost care, personal treatment.