Role Overview

Accurately complete patient accounts per departmental protocols, policies, procedures, and regulatory compliance.
Perform pre-admission, admission, pre-registration, and registration functions.
Ensure insurance requirements are met before patient arrival.
Inform patients of financial liability prior to service.
Arrange payment options with patients and screen for government funding eligibility.
Analyze insurance coverage and benefits to ensure timely reimbursement.
Obtain prior authorizations and certifications as needed.
Facilitate payment options for uninsured patients.
Investigate accidents to determine liability and appropriate payer sources.
Accurately admit, register, and pre-register patients with demographic and financial data.
Resolve insurance claim rejections and denials promptly.
Calculate and collect patient payments; reconcile daily cash deposits.
Evaluate diagnoses for Medicare policy compliance.
Ensure all accounts are processed accurately and efficiently.
Compile departmental statistics for budgets and reporting.
Explain bills per PRMO credit and collection policies.
Initiate and manage appropriate collection efforts and assist with payment plans.
Refer patients for financial counseling as needed.
Assess need for and process third-party sponsorships.
Review insurance policies and funding materials to determine payment sources.
Notify physicians of patients experiencing financial hardship.
Complete managed care waiver forms for out-of-network patients.
Update billing systems with accurate insurance status.
Refer patients to Manufacturer Drug Programs as needed.
Greet and assist patients and visitors; explain policies and resolve issues.
Gather documentation to support inquiries and complaints.
Provide departmental coverage upon request.
Obtain authorizations based on insurance guidelines and contracts.
Accurately document in billing systems per policy and procedure.
Enter and update referrals as needed.
Communicate with insurance carriers to resolve clinical and coverage issues.

Requirements

High school diploma required; some post-secondary education preferred.
Two years of experience in hospital or clinical service access, physician office, or billing/collections, OR
Associate’s degree in a healthcare-related field and one year of public-facing experience, OR
Bachelor’s degree and one year of public-facing experience
Working knowledge of related business functions is desirable.
Must possess excellent oral and written communication skills.
Strong interpersonal skills; able to build service-oriented relationships.
Understanding of and adherence to institutional policies and procedures.

Benefits

Excellent communication
Exceptional customer service skills
Support your personal well-being
Excellent work environment

Behavioral Health Counselor – Therapist

About this role