Financial Counselor, Pre-Collect and Price Estimate

Overview

Financial Counselor, Pre-Collect and Price Estimate

Position Summary:

This position is responsible for ensuring all insurance and pre-collection requirements are met prior to patient’s surgical and/or office procedures and to inform patients of their financial responsibility. Additionally, this role communicates patient financial liability, establishes payment plans, and processes delinquent patient accounts to external collection agencies.

• Pre-Collect and Good Faith Estimates
  • Communicate with patients, face-to-face or by telephone, collecting on patient financial liability in advance of medical services being performed.
  • Review and verify insurance benefits for all proposed or scheduled procedures.
  • Review and verify insurance eligibility for scheduled patients.
  • Review patient account ledgers and contact patients to initiate pre-collection procedures.
  • Calculate and collect payments appropriately for all patients.
  • Perform price estimates for medical services using price estimate technology and insurance company portals to obtain procedure claim estimates and calculate patient responsibility.
  • Accurately complete good faith estimates in the required time frames.
  • Communicate with patients in a compliant and professional manner.
  • Establish down payment and payment plan requirements prior to clinic staff scheduling all elective procedures.
  • Complete pre-collection on accounts promptly and efficiently to reduce patient receivables and bad debt.
  • Perform duties necessary to ensure all accounts are processed accurately and efficiently.
  • Perform other duties as assigned by the Supervisor.
• Collections
  • Communicate with patients, face-to-face or by telephone, collecting on patient financial liability.
  • Process patient accounts promptly and efficiently to reduce receivables and bad debts.
  • Monitor payment plans for adherence to defined payment plan guidelines.
  • Review patient account ledgers and contact responsible parties to collect monies on delinquent accounts.
  • Participate in automated telephone work queue collecting on past due balances.
  • Place delinquent accounts with collection agencies.
  • Consult with patients regarding their financial responsibility, current benefits, and limitations on coverage for their plan product and payment options.
  • Review and process bankruptcy paperwork.
  • Review and process deceased patient accounts.
  • Performs other duties as assigned by the supervisor.
• Customer Service and Communications
  • Communicates with patients, insurance carriers and other outside entities in a professional manner. Identifies solutions and responds professionally to patient concerns. Uses appropriate grammar and demonstrates tact and diplomacy in patient interactions, by phone and in person.
  • Diffuses negative situations with patients and maintains a pleasant and professional tone during stressful circumstances and heavy workload.
  • Communicates with staff members in a professional, pleasant manner; shares information relevant to work, and asks and answers questions related to improving department performance.
• Teamwork
  • Works cooperatively with coworkers, providers, and management.
  • Shares knowledge and insights with co-workers in a constructive manner.
  • Willingly provides coverage to the department, staying beyond scheduled ending time when schedule demands; maintains workflow in the department without direct supervision.
  • Addresses conflicts directly and professionally.
  • Respects others regarding breaks, equipment use, and noise in the department.
• Policies and Procedures
  • Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and related documents.
  • Provides assistance and support to leadership in implementing policies and procedures as necessary.
  • Actively participates in training and daily work activities by adhering to all policies and procedures in compliance and risk management programs.

High school diploma/GED required; some post-secondary education is preferred. This position requires a minimum of 2 years of previous medical billing/collections experience in a medical office or insurance payer setting. Experience in healthcare patient accounting or revenue cycle department, including knowledge of insurance deductibles, co-insurance, and price estimate processes, is also required. Previous experience working in an electronic medical record system is essential.

Able to organize and prioritize responsibilities; demonstrated ability to work independently with little immediate supervision; understanding of basic mathematical principles; knowledge of CPT, ICD-10 and HCPCS codes; ability to communicate using appropriate professional grammar, tact and diplomacy; basic computer skills and comfortable working with Microsoft Office programs; excellent customer service and communication skills; able to diffuse stressful situations and maintain a pleasant and professional tone;

able to work effectively with all levels of…