Job Description

University of Utah Job Description

Job Summary

Supports billing and collections processes by verifying eligibility and benefits, collecting co-pays, obtaining pre-authorizations, and maintaining patient insurance, billing, and demographic information. May also prepare charges and bills, post payments, and perform follow up on accounts.

Qualifications

Two years of billing experience (medical setting preferred) or equivalency (one year of education can be substituted for two years of related work experience); knowledge of debits and credits, insurance company policies, and medical terminology; and spreadsheet, word processing, customer service, and demonstrated human relation and effective communication skills required.

Knowledge of coding may be preferred for some positions.

This position is patient-sensitive and must fulfill all associated vaccination requirements, or be approved for an exemption, prior to the first day of work. We protect our patients, coworkers and community by requiring all patient-sensitive employees to be immunized according to CDC standards and hospital policy. Limited exemptions may be made for documented medical contraindications or religious beliefs that object to vaccinations.

Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.

Disclaimer

This job description has been designed to indicate the general nature and level of work performed by employees within this classification.  It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to the job.

Essential Functions

1. Verifies patient benefits and eligibility.
2. Collects co-pays and deposits, and maintains cash box and log of payments.
3. Obtains or confirms pre-authorization for procedures. Enters or checks patient registration demographics and makes corrections as needed. Documents insurance coverage and authorization information in patient account notes.
4. Meets with patient and/or family to explain insurance coverage, treatment costs, hospital billing policies, and prompt pay or financial hardship discounts.
5. Interviews patients to determine eligibility for programs, and helps them complete financial disclosure forms if necessary.
6. Responds to incoming calls regarding account status from patients and insurance companies.
7. Follows up on unpaid accounts and insurance company rejections or denials. Follow up may include checking claim status with insurance company, skip tracing, or correction of bad addresses.
8. Enters patient charges in computer, posts payments, and/or does billing for clinic.
9. Responds to staff or patient questions regarding insurance procedures and policies.
10. Carries out special projects as assigned by supervisor.

Problem Solving

The Financial Counselor directly affects unit or clinic profitability, because correct insurance information and proper authorization is mandatory for successful collections. Within the framework of hospital policy, the incumbent has the authority to offer prompt payment discounts, determine patient eligibility for programs or sliding scales, recommend charity adjustments, and obtain authorization for procedures. The incumbent must observe Medicare standards and CPT and ICD-10 codebook guidelines, maintain patient confidentiality, and interact professionally with patients and/or patient representatives who may be in sensitive or stressful situations.

Comments

Work Environment and Level of Frequency typically required

Nearly Continuously: Office environment.

Physical Requirements and Level of Frequency that may be required

Nearly Continuously: Sitting, hearing, listening, talking.

Often: Repetitive hand motion (such as typing), walking. 

Seldom: Bending, reaching overhead.

The staff member must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his or her assigned unit.  The individual must demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.