Counselor

• Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions.
• 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.
• Obtain prior authorization/pre-certification for clinic procedures as required by insurance carriers as needed according to PRMO guidelines.
• Obtain insurance verification and inform patients of their financial liability.
• Arrange payment options for financially liable patients.
• Pre-register patients with accurate patient demographics and financial data as needed.
• Resolve insurnace claim denials/rejections.
• Calculate and collect payments appropriately for all patients.
• Resolve appropriate WQ edits.
• Inform attendin physician of patient financial hardship.
• Update billing system to reflect the current insurance status of the patient.
• Assist with department coverage at the front desk, as needed.
• Reconcile necessary blling and WQ issues.
• Gather necessary information and documentation to support proper handling of billing inquiries and complaints.

Financial Care Counselor

Genetics Counselor