ABOUT AUSTIN REGIONAL CLINIC:
Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit https://www.austinregionalclinic.com/careers/
PURPOSE
Prepares estimates for medical services prior to treatment, educates patients and collects payment when appropriate. Responsible for multiple specialties, multiple locations and/or high dollar authorizations simultaneously. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.
ESSENTIAL FUNCTIONS
Financial Counselor
- Utilizes Medical Present Value’s Patient Responsibility Pricer application to prepare estimates for medical services. Obtains appropriate eligibility and benefits information and, together with the contractual allowable data, creates estimates.
- Contacts patients to provide a verbal estimate and attempts pre-collection of the patient responsible amount. Advises patient that the estimate may not reflect all charges as they vary based on services provided. Educates patients on their financial responsibilities.
- Mails a formal copy of the estimate and a letter to the patient. Documents details in account notes.
- If patient is present for estimate creation, obtains Patient’s signature on estimate and attempts to collect patient responsible mount.
- Maintains file copies of estimates.
- Returns telephone calls within timeframes established by department.
- Interacts with providers’ office and the billing office staff.
- Helps enroll patients into third party assistance programs
- Works with CBO in processing EFT payments received from prescription assistance programs
- Works with clinical staff and physicians to make modifications to orders as appropriate based on patient feedback and benefits
- Collaborates with outside vendors for patients that require services outside of ARC
- Works within and maintain access to financial and authorization portals
Customer Service
- Receives inbound telephone calls from internal and external customers. ie. Patients, Insurance Representatives.
- Asks appropriate verification questions prior to releasing confidential patient information in accordance to company policy/HIPAA guidelines.
- Reviews explanation of benefits documents with knowledge and ability to explain information to patients/customers.
- Provides financial counseling service/payment arrangements to walk-in patients with outstanding account balances.
- All actions are documented with clear and accurate documentation in the Account Notes.
- Receives patient refund request information and forwards to Refunds processing.
Account Transactions/Insurance
- Reviews account transactions for accuracy.
- Uses appropriate transaction and ANSI codes per Posting guidelines.
- Reviews and documents patient correspondence. Contacts patients to acknowledge receipt of correspondence in a timely manner, whenever necessary.
- Obtains updated insurance information and forwards to the Registrations unit for eligibility verification.
- Utilizes Payor Websites efficiently and maintain confidential security passwords.
Collections
- Receives credit card payments via telephone and posts payment accordingly.
- Establishes payment plans per Payment Agreement guidelines.
- Works closely with Collections Department and/or directly with Customers on payment of balances due.
- Sets up accounts with payment plan information and clearly documents the terms of the agreement.
- Consults with Supervisor prior to offering discounts for non-covered services.
- Meets 1106 collections expectations.
Other
- Performs all of the tasks of the PSC and Sr. PSC as needed or assigned.
- Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
- Regular and dependable attendance.
- Follows the core competencies set forth by the Company, which are available for review on CMSweb.
- Works holiday shift(s) as required by Company policy.
OTHER DUTIES AND RESPONSIBILITIES
- Assists supervisor with disputed accounts which may require additional follow up and/or rework.
- Keeps complete, accessible, and current Payor information.
- Provides assistance to coworkers as requested and/or necessary.
- Responds professionally and effectively to questions from external sources, i.e., customer or carrier, and internal sources, i.e., provider or management team.
- Attends required in-services/training sessions/department meetings.
- Meets performance competency standards for Registrations and Patient Accounts.
- Performs other duties as assigned
QUALIFICATIONS
Education and Experience
Required: High school diploma or GED. One or more years of financial counselor experience. Experience with CPT and ICD coding.
Preferred:. Some higher education. Bilingual in English/Spanish.
Knowledge, Skills and Abilities
- Must have knowledge of legislative and private sector third party regulations and guidelines.
- Must have excellent verbal and written communication skills in order to communicate clearly and effectively to all levels of staff and the public.
- Ability to sit for extended periods of time at a computer workstation.
- Ability to engage others, listen and adapt response to meet others’ needs.
- Ability to align own actions with those of other team members committed to common goals.
- Excellent computer and keyboarding skills, including familiarity with Windows.
- Excellent verbal and written communication skills.
- Ability to manage competing priorities.
- Ability to perform job duties in a professional manner at all times.
- Ability to understand, recall, and communicate, factual information.
- Ability to understand, recall, and apply oral and/or written instructions or other information.
- Ability to organize thoughts and ideas into understandable terminology.
- Ability to apply common sense in performing job.
Work Schedule: Monday- Friday 8AM-5PM