Patient Access Rep III, Financial Counselor

Job Summary

The Patient Access III (Financial Counselor) assists the patient care team, staff, vendors, patients and their families with financial issues; obtaining eligibility and benefit information, authorizations, patient demographic information; collecting deductibles and patient liability; presenting and explaining payment options for collections of monies due; coordinating facilitation by pursuing eligibility and benefits for services rendered which are determined to be necessary in the continuum of care. In addition, the Financial Counselor secures scheduled/unscheduled hospital and professional services by verifying insurance eligibility and benefits coverage, and by securing insurance pre-certification and/or authorization for inpatient and/or outpatient services; and provides and collects estimated patient liability amounts.

Licensure and Certification:

• High risk workplace violence certification to be completed within 6 months of hire
• Certified Revenue Cycle Representative (CRCR) certification preferred

Education:

• Minimum High School graduate or GED equivalent

Experience:

• Minimum three (3) years of hospital, medical/doctor office,  and/or healthcare setting; providing pre access or billing services
• Experience preferred in insurance eligibility and benefits coverage verification, obtaining pre-certification and/or authorization for medical services, and providing explanations and/or estimates of patient financial responsibility.

Knowledge and Skills:

• Knowledge of third party reimbursement especially HMO/PPO
• Basic medical terminology.
• Excellent customer service skills, organization, and communication (verbal and written)

Physical Demands – Clerical/Administrative Non-Patient Care:

• Frequent sitting and standing/walking with frequent position change.
• Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.
• Occasional/intermittent reaching at or above shoulder level.
• Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.
• Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.
• Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.