This position combines financial counseling and pre-certification duties. As Financial Counselor, this position is responsible for establishing acceptable financial arrangements on assigned patient accounts by way of securing sponsorship form various federal, state, and county agencies or arrange personal payment, in order to meet the patient?s financial obligation to the Clinic and ensure reimbursement accountability. As Pre-Certification Coordinator, this position is responsible for obtaining authorizations for inpatient hospital admissions and authorization for all outpatient procedures.
Talent Pool: Corporate Services/Professional
Assists insurance carriers of pre-certification issues (i.e. clinical documentation, insurance information, and patient demographics). Obtains benefit information on each outpatient/inpatient procedure (via online access to the internet as well as phoning the carriers that are not web-based).
Assures timely response to Third Party payers requests for additional information.
Contacts patients regarding their benefits and/or co-pays and coverage information for all outpatient procedures.
If the patient does not qualify for any sponsorship programs, the position will determine patient payment responsibility utilizing Cone
•s Charity Care Policy.
Obtains pre-certification for admissions and outpatient procedures. Researches and resolves pre-certification denials.
Relays all medical questions to appropriate clinical staff and documents legibly.
Responsible for initial and follow-up contact for all patients scheduled without sponsorship. Screen and counsel patients and/or their family regarding financial eligibility for possible assistance from carious sponsoring federal, state, and county funded programs that provide reimbursement for medical expenses.
EDUCATION: High School Diploma or equivalent, Required
EXPERIENCE: 2 years, Required
2 years medical office experience or Medical Office Management/Coding advanced education required.
2 years Medical Manager experience/training required.
Extensive knowledge of ICD-9 & CPT-Coding required.
LICENSURE/CERTIFICATION/REGISTRY/LISTING: REQUIRED
PREFERRED
BCLS certification preferred