Financial Counselor Float
South Tampa Location
This job description does not constitute an offer of employment or employment contract.
Individuals responding to job postings are considered to be applicants for a particular position only after they have been invited to complete the company's official printed employment application form. Florida Cancer Specialists is an equal opportunity employer.
**This a Float Position - Travel to office within the Tampa area is required. **
Reports to: Clinic Financial Manager
Position Summary: Responsible for monitoring and collecting the financial responsibilities of our patients. The Financial Counselor must keep patients’ insurance benefits up to date in OncoEMR and Centricity and view the patients’ services for diagnosis and insurance coverage appropriateness. Also performs the daily tasks of Managed Care and Financial Counselor.
Required Qualifications: High school diploma or GED. Experience working in a healthcare field, preferably in a clinical setting or business office is required. Excellent verbal and communication skills needed. Insurance knowledge requirements including: understanding of medical terminology, managed care authorization process, ICD9 and CPT codes, collection experience and ability to calculate and collect patients’ responsibility and insurance co-pay/coinsurance.
Key Performance Areas:
1. Monitor daily/weekly schedules to identify and review all HMO, Medicaid, Self Pay accounts according to the policies and procedures established in the Managed Care training manual. Report all areas of concern to Clinic Finance Manager.
2. Develop a daily accounts receivable report that will be handed out to the front office staff detailing the amount of money to collect from each patient.
3. Meet with new patients upon first office visit. Confirm demographic information; explain insurance benefits to patient, detailing their financial responsibility, obtain necessary consent form signatures, including HIPAA policy. Input changes and other pertinent information obtained into the computer.
4. Identify patients not paying according to their treatment plan or with ongoing account balances and make arrangements to meet with them prior to their visit.
5. Identify patients that are having first time chemotherapy and will have a financial responsibility, complete an estimate of service form to go over with the patient.
- Meet with those patients prior to them receiving their first chemotherapy treatment. Explain what their financial responsibility will be and determine a method of payment for the patient.
- Request authorizations as required for internal services as well as outside tests, hospital admittance and referrals to doctors. Document all information in Onco/EMR and Centricity.
8. OncoEMR offices: Review managed care report continuously for drug approvals.
9. Drug approval requests should be handled as quickly as possible. The financial counselor must review all treat regimes for diagnosis appropriateness based on the clinic policy or accepted compendia of the patient’s insurance. The financial counselor will also determine if prior authorization is required and request the authorization if needed. Request approval on special order drugs from Clinic Financial Manager. Meet with physician if drug is determined to be a non-covered medication.
10.Explain and have patient sign waivers when new drugs are given without the proper billing codes, as well as off label for diagnosis or lab values.
11.Register patients that will be receiving newly approved FDA drugs with appropriate “Hot Line” to support reimbursement if insurance carrier refuses treatment or payment.
12.Verify eligibility of Medicaid patients and keep practice management information system updated for any changes.
13.Update Onco/EMR and Centricity for any insurance changes made. Verify benefits input into system. For those patients with charts, make sure to change the chart label.
14.Keep the demographic screens and insurance benefits updated continuously in Onco/EMR and Centricity.
15.Work closely with nurses, doctors, patient service specialists and office managers to collect co-pays, coinsurance, and resolve any insurance and self pay issues.
16.Work closely with the Clinic Financial Manager to ensure that patient financial obligations are being met, self pay patients are properly handled, and necessary drugs are approved before being ordered.
17.Assist patients in completing the patient assistance application and any other forms that FCS requires the patient to complete.
- Make use of the patient assistance program for under-insured patients.
- Maintain and ensure the confidentiality of all patient and employee information at all times.
- Will be expected to work overtime when given sufficient notice of required overtime.
- Keep work area and records in a neat and orderly manner.
- Maintain all company equipment in a safe and working order.
- Comply with all Federal and State laws and regulations pertaining to patient care, patients’ rights, safety, billing, and collections. Adhere to all FCS and departmental policies and procedures, including IT policies and procedures and Disaster Recovery Plan.
Expectation for all Employees:
Support the organization’s mission, vision and values by exhibiting the following behaviors: excellence and competence, collaboration, innovation, respect, personalization, commitment to our community, accountability and ownership.
This job description in no way states or implies that the listed duties are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related instruction and to perform other job-related duties requested by their supervisor or other management personnel. Other duties may be assigned to meet business needs. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Essential Physical Requirements:
- Ability to travel independently throughout the facility to access information from other departments.
- Ability to sit for long periods of time.
- Ability to operate an automobile for travel to other offices.
- Ability to talk, hear, type, reach, and grasp with hands.
Essential Mental Requirements:
- Ability to work under stress, with interruptions and deadlines.
- Ability to process verbal information and input this information into computer system.
- Ability to follow complex instructions.
- Ability to master basic math skills.
- Ability to think logically in following procedures and instructions.
- Ability to think logically and make decisions.
- Ability to utilize the FCS information system.
Essential Technical/Motor Skills:
- Ability to enter and retrieve data from computer.
- Ability to operate modern office business machinery.
- Ability to operate phone system.
- Ability to operate a motor vehicle for travel to other offices.
Essential Sensory Requirements:
- Ability to converse in calm and friendly manner.
- Ability to view data on the FCS information system and in various written formats.
- Ability to communicate on the phone.
- Ability to effectively communicate and interact with coworkers, insurance company staff, hospital staff, patients, public, physicians and their staff.