Job Title: Financial Care Counselor

Job Description

Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, including 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 before they arrive for services. Arrange payment options with the patients and screen patients for government funding sources. This position requires high production accuracy in accordance with established business processes or regulations and requires a working knowledge of compliance principles.

Responsibilities

• Analyze insurance coverage and benefits for service to ensure timely reimbursement.
• Obtain all Prior Authorization Certification and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Determine if the patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
• Admit, register, and pre-register patients with accurate patient demographic and financial data.
• Resolve insurance claim rejections/denials and remedy expediently.
• Calculate and collect cash payments appropriately for all patients.
• Reconcile daily cash deposit.
• 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.
• Explain bills according to PRMO credit and collection policies.
• Implement appropriate collection actions and assist financially responsible persons in arranging payment.
• Make referrals for financial counseling.
• Determine the necessity of third-party sponsorship and process patients in accordance with policy and procedure.
• Examine insurance policies and other third-party sponsorship materials for sources of payment.
• Inform attending physicians of patient financial hardship.
• Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level.
• Update the billing system to reflect the insurance status of the patient.
• Refer patients to the Manufacturer Drug program as needed for medications.
• Greet and provide assistance to visitors and patients.
• Explain policies and procedures, and resolve problems.
• Gather necessary documentation to support proper handling of inquiries and complaints.
• Assist with departmental coverage as requested.
• Obtain authorizations based on insurance plan contracts and guidelines.
• Document billing system according to policy and procedure.
• Enter and update referrals as required.
• Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment.

Essential Skills

• High school diploma or equivalent required; post-secondary education or additional training in a relevant profession preferred.
• Two years' experience working in hospital service access, clinical service access, physician office, or billing and collections. Or, an Associate's degree in a healthcare-related field and one year of experience working with the public. Or, a Bachelor's degree and one year of experience working with the public.
• Excellent communication skills, both oral and written.
• Ability to analyze data, perform multiple tasks, and work independently.
• Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors.
• Must be able to understand and comply with policies and procedures.

Additional Skills & Qualifications

• Post-secondary education or additional training in a relevant profession preferred.
• Experience in a healthcare-related field or working with the public preferred.

Work Environment

This position is based at a fast-paced Gastroenterology clinic. The work schedule is Monday to Thursday from 8 AM to 5 PM, and Friday from 8 AM to 12 noon. The facility is located at Health Surgery and Breast Health Mooresville, Mooresville, NC. The role requires a high level of interaction with patients and healthcare providers, ensuring a professional and service-oriented environment.

Pay and Benefits

The pay range for this position is $18.72 - $22.87/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Mooresville,NC.

Application Deadline

This position is anticipated to close on Apr 22, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $19 - $23