Patient Financial Counselor

at  Providence

REQUIRED QUALIFICATIONS:

• Computer and / or data entry

PREFERRED QUALIFICATIONS:

• College education in medical office, medical information or related medical business field
• 2 years Hospital or medical business office functions
• Medical insurance and third party payer requirements
• Microsoft Office applications including Word, Excel and Outlook
• Customer Service
• Financial Counseling
• Web-based software

• Reviews referred and wait listed patient insurance to determine coverage and eligibility prior to scheduling.
• Obtains insurance authorizations for, pre, peri, and post-transplant patients.
• Counsels patients undergoing evaluation as to the financial impact of transplant, reviews their financial statement, and immunosuppressant drug charges and provides patients with paperwork describing their out-or-pocket expenses pre, peri, and post-transplant.
• Coordinates with the Transplant Social Worker for assistance in obtaining grants, special assistance funds, as well as providing information to the social worker on potential compliance or other pertinent issues.
• Prepares for and participates in Patient Selection Committee meetings in terms of financial clearance of potential transplant candidate and VAD patients.
• Assists in resolving financial problems for transplant program patients, which includes both verbal and written correspondence with insurance companies, hospitals, physician billing services, patients, and other groups.
• Enters all necessary data and documentation into the electronic medical record.
• Remains abreast of all Federal and State regulations regarding organ transplant reimbursement issues..
• Completes transplant program charge verification on a daily basis.
• Places the specialty billing flag on living donor and transplant candidate accounts. Ensures the transplant guarantor is in place on all transplant accounts.
• Registers all pre-transplant patients and donors prior to clinic appointments, radiology, and consults.
• Obtains an authorization on all out-of-network patients. Communicates these authorizations to contracting. Ensures that the fully executed SCA or LOA is in the patient’s electronic medical record.
• Prepares invoices with the appropriate account and sub-account for reimbursement for patient examination work up