Counselor

• Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies.
• Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability prior to arrival for services.
• Arrange payment options with the patients and screens patients for government funding sources.
• Analyze insurance coverage and benefits for service to ensure timely.
• Obtain authorizations based payment on insurance plan contracts and guidelines.
• Document billing system.
• Explain bills provides assistance to visitors and patients.
• Calculate and according to PRMO credit and collection policies.
• Implement appropriate collect cash payments appropriately for all patients.
• Reconcile daily necessity of third party sponsorship and process patients in accordance reimbursement.
• Obtain all Prior Authorization Certification and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Admit, register and pre-register patients with accurate patient demographic and financial data.
• Resolve insurance claim rejections/denials and remedy expediently.
• Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
• Perform those duties necessary to ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgetary and reporting purposes.
• Make referral for financial counseling.
• Determine with policy and procedure. Examine insurance policies and other third party sponsorship materials for sources of payment.
• Inform attending physician of patient financial hardship.
• Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level.

Financial Care Counselor – Cancer Center

Financial Care Counselor