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The Financial Counselor goes over insurance and costs of visits with patients. In cases which insurance is expected to cover the cost, the financial counselor will make sure all paperwork is in order and collect forms for prior authorization, if needed. In cases where patient does not have insurance coverage, the financial counselor will work with the patient to obtain required documentation to be placed on the sliding fee scale. If payment is required, the financial counselor may collect the payment and update the patient billings records. If a patient needs assistance with paying, the counselor will help the patient find payment assistance.
- Verifies patient insurance coverage prior to date of service.
- Responsible for the attainment of required authorizations/certifications for intended services and procedures from insurance carriers prior to patient visit.
- Responsible for patient pre-registration.
- Assists patients in completing paperwork, verifies family income and size and places client appropriately on sliding scale and explains billing policies and fees to patients.
- Answers patient questions, identifies and resolves patient billing issues.
- Enters information into Electronic Health Record (EHR).
- Issues notices and revised fee agreements, compiles data, and enters information for sliding scale reduction updates.
- Completes and/or inputs billing/clinical transaction information in EHR.
- Maintains current knowledge regarding third-party and first-party payment procedures and regulations as well as preferred provider agreements.
- Completes patient check-out.
- Assists patients and employees with client account questions as they occur.
- Handles patients with possible Medicaid eligibility criteria and/or unresolved account questions.
- Assist patients with accessing community-based resources including, but not limited to resources to help in obtaining required documentation for registration.
- Complete all telephone and face to face contacts with patients in a timely and professional manner.
- Complete enrollment forms and other needed documentation and document in approved format in a timely manner.
- Reconciliation of outsourced laboratory bills and insurance coverage.
- Collaborate with Community Health Workers and Navigators regarding patient resources.
- Work with all front office volunteers and provide training as needed.
- Assist patient to schedule medical, dental, behavioral health and social service appointment as needed or requested.
- Completes data entry of all patient/client information to include all demographic records.
- Keeps current with trends and developments related to essential job competencies.
- Ensures strict confidentiality of financial records, adhering to established HIPAA guidelines and regulations as well as clinic policies and procedures.
- Provide back up for other Practice Management staff during absences.
- Ability to work an occasional Saturday and evenings as requested.
- Completes all other duties as assigned by Practice Coordinator and Practice Manager.
- High level accuracy and attention to detail
- Proficient knowledge of all Microsoft Office products
- Ability to relate to a broad and diverse spectrum of the community.
- Ability to work under pressure in a fast-paced environment.
- Ability to prioritize and perform multiple tasks.
- Ability to understand and present verbal instructions and to exchange verbal information.
- Ability to establish and maintain effective, courteous working relationships with patients, coworkers and others.
Physical Demands/Working Conditions:
- Intermittent physical activity including walking, standing, sitting, stooping, lifting boxes and files under 25 pounds and lifting.
- Potential exposure to virus, disease and infection from patients in working environment.
- May be required to work extended periods based on business need.
The above information is intended to describe the most important aspects of the job. This job description is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required in order to perform the work. Duties, responsibilities and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. The KC CARE Health Center is committed to providing equal employment opportunity/affirmative action (EEO/AA) to all job applicants and employees.
- Minimum high school diploma; college credit preferred
- Knowledge of medical coding, billing and medical terminology.
- Knowledge of Medicare, Medicaid and private insurance.
- Some experience with payables, receivables and invoicing.
- Working knowledge of medical office billing and electronic submission