Become A Finance Counselor

* Verification, Authorization and ComplianceMaintains up-to-date knowledge of specific registration requirements for all areas, including but not limited to: Main Admitting, OP Registration, ED Registration, Maternity, and Rehabilitation units.
* Ensures the pre-registration process is complete for all assigned accounts at least 5-days prior to the scheduled date of service whenever possible
* Verifies insurance eligibility and benefits on all assigned accounts using electronic verification systems or by contacting payers directly to determine level of insurance coverage.
* When contacting payers directly, utilizes approved scripting
* Obtains referral, authorization and pre-certification information and documents this information in the ADT system
* When appropriate, ensures the payer receives a Notice of Admission on all admissions, scheduled and non-scheduled, with 24-hours or the next business day
* Meets CMS billing requirements for the completion of the MSP, issuance of the Important Message from Medicare, issuance of the Observation Notice, and other requirements applicable and documenting completion within the hospital’s information system for regulatory compliance and audit purposes
* Follows up on missing authorizations.
* If authorization is not obtained within 48-hours prior to service, contacts patient to advise them of their financial responsibility
* Thoroughly and accurately documents insurance verification and authorization information in the ADT system, identifying outstanding deductibles, copayments, coinsurance, and policy limitations, and advises patient and collects amount due at or before the time of service
* Identifies any outstanding balance due from previous visits, notifies patient during the financial clearance process and requests patient payment
* Sets up payment plans for patients who cannot pay their entire current copayment and / or past balance in one payment
* Explains the Payment and Billing Assistance Program to all patients regardless of financial concerns or limitations
* Interviews self-pay patients to identify potential eligibility for government aid and / or other payer sources, including Medi
* Cal / Medicaid presumptive eligibility.
* Follows appropriate policy and/or refers to eligibility vendor
* Understands and follows the “Delay / Defer” policy and escalates accounts that do not meet financial clearance requirements to Patient Registration leadership immediately.
* For patients who qualify, offers a flat rate discount based on estimated charges, percent of reimbursement, and / or hospital specific policy and procedure
* Thoroughly and accurately documents the conversation with the patient regarding financial liabilities, agreement to pay and / or payment assistance
* Clarifies division of financial responsibility if payment for services is split between a medical group and an insurance company.
* Ensures this information is clearly documented in the ADT system
* Verifies medical necessity check has been completed for outpatient services.
* If not completed and only when appropriate, uses technology tool to complete medical necessity check and / or notifies patient that an ABN will need to be signed
* Responsible for reviewing assigned accounts to ensure accuracy, and to ensure require documentation is obtained and complete
* Financial Processing and Assistance:Provides financial clearance services to self-pay patients prior to discharge or within 24 business hours
* Provides on-site customer service assistance for walk-in patients with billing-related questions
* Provides information to hospital personnel who are seeking answers to financial concerns on their patient’s behalf
* When needed, works closely with Case Management / Utilization Review in ensuring services are appropriate for level of care provided (inpatient vs.
* outpatient and vice versa

* Provide varying degrees of financial needs analysis, recommendations and education depending on the customer’s reason for contacting Principal.
* Through consultation with the consumer, uncover the needs and wants of an individual in a manner that often provides them with information they didn’t know to ask.
* Identify and deliver appropriate financial education and solutions for the customer based upon our Digital Advice solution(s).
* Take ownership of each customer interaction to build relationships with our customer base.
* Education on the benefits and value each individual will experience with our Digital Advice solution.
* If additional products are needed, partner with other SME’s to introduce those solutions to the customer, focusing on a holistic approach to managing the client’s needs in alignment of a “One Principal” culture.
* Close business through timely and frequent follow-ups with our prospects and customers.
* Ensure safe, complete and accurate handling of all customer data, documents and applications.
* Complete and maintain all required regulatory and compliance related training, licensing and designations.
* Perform other job-related duties and projects as needed
* Qualifications

* Performs financial counseling process on all patients prior to treatment, which includes patient financial obligations, billing practices and establishing payment arrangementsAssists patients in obtaining financial assistance (i.e. Medicaid, drug replacement), outside assistance (i.e. transportation or other community services), and all appropriate forms filled out
* Ensure all insurance, demographic, and eligibility information is obtained and entered into the system in an accurate manner
* Performs insurance verification process on all third party payers.
* Obtains initial and subsequent preauthorization for services and surgeries
* Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment.
* Ensures appropriate signatures are obtained on all necessary forms
* May assist with resolving large dollar amounts
* Utilizes the Summary of Patient Reimbursement and Liability form and obtains appropriate approvals as required
* Documents financial counseling process and forwards to Billing Office

* Performs registration and pre-registration process functions: Interviews, pre-register and registers patients; Enters all information received accurately and completely in system; Obtains signatures on required forms; Scans all patient documents received.
* Performs registration and pre-registration financial and collection functions: Contacts payers on the phone or via websites for required authorization and insurance eligibility; Confirms insurance coverage through online insurance verification (HDX) or contacts insurance company directly; Provides patient with required information regarding billing and obtains signatures on required forms; Collects and receipts patient payments.
* Performs pre-registration work list maintenance/documentation, i. e., Ontrac and Outlook scheduling system.
* Performs reception functions; answers phone calls, meets and greets patients, directs and escorts patients to scheduled service area, contacts physicians when patients present are without orders, notifies the appropriate Radiology department of patient’s arrival.
* Performs Order Entry/Diagnosis coding functions: Accurately enters patient exam orders in Misys, Completes order entry processes for Raisler Testing Center and ensures that appropriate diagnosis ICD
* code is entered for test ordered

* Review and approve a high volume of vouchers for compliance with House rules and apply appropriate accounting strip information.
* Accurately enter payment requests into PeopleSoft.
* Quickly resolves invoice collection issues in tandem with the Accounting Department.
* Identifies potential duplicate payments and takes appropriate action.
* Recommend to management changes in procedures used to establish the propriety of each payment and determine conformance with the House regulations and applicable statutes.
* Assist in the timely filing of accurate official files.
* Perform other official duties as assigned