Financial Counselor/Biller

# Positions
Office and Administrative Support
Job Status
Regular Full-Time
38051 Market Square

Job Description

Financial Counselor / Biller

Department:               Rheumatology

Job Summary:           Responsible for verifying and collecting patient due balances, posting charges, and reviewing journals for infusion visits.

Reports to:                 Office Manager

Position Level:           5



Essential Functions of the Position:

  • Financial Counseling
    • Verifies eligibility and benefits for all patients in Infusion Lab
    • Calculates patient financial responsibility for treatments
    • Meets with patient to review benefits and explain patient’s financial responsibility
    • Coordinates payment plans if approved by Patient Collections Manager
    • Reviews Infusion schedules prior to date of service and indicates in the appointment comment field amount for Check In Clerk to collect for each visit
    • Serves as point of contact for all Infusion patients regarding insurance eligibility and benefits issues
    • Requests referrals and obtains authorizations from insurance companies for all Infusion lab appointments
    • Enters referral authorization information into Practice Management System
    • Prepares patient education packets for new chemo patients
    • Schedules patients for education meeting
  • Patient Assistance Programs
    • Maintains current files and information on all patient assistance programs by scanning to chart and copying to collector
    • Reviews available programs with patients 
    • Assists patients with completing documents and forms needed by assistance programs
    • Responsible to follow up on status of assistance programs and tracking coverage available on programs
    • Handles calls from pharmacy companies and foundations
    • Meets with Pharmacy reps regarding patient assistance programs
  • Assists traffic on phones
    • Makes appointments
    • Takes messages
    • Assists with medication refill requests
    • Handles patient requests or needs
    • Assists vendors
    • Direct calls to the proper individual
  • Posts charges and reviews journals
    • Posts chemotherapy and hospital charges
    • Makes corrections to journals as needed
    • Ensures ailment, insurance plan, provider, finance, department, date, diagnosis, and CPT are correct for each charge
    • Reviews note if charge is in question. If unable to resolve, contacts office staff to clarify issue.
    • Ensures correct NDC identifications are noted and attached to appropriate CPTs
    • Reviews billing with providers when applicable
    • Addresses all tasks in a timely manner
    • Works hold report on a bi-weekly basis and releases claims when appropriate. Follows up if no response.
    • Works closely with Physician Support Services when requests are made to place provider charges on hold for audit / review, as well as, release claims once reviewed.



Additional Responsibilities:

  • Maintains an organized and clean work area
  • Serves as back up to front and back office
  • Performs other incidental and related duties as required and assigned


Physical and Mental Demands:

  • Normal physical ability; able to sit for long periods
  • Normal concentration and normal complexity of decision making
  • High level verbal and written communication skills
  • Above average ability to manage multiple tasks simultaneously


Occupational Exposure:

  • Low risk exposure to bloodborne pathogens and chemical hazards


Job Qualifications:

  • High school graduate or GED equivalent
  • Strong customer service orientation
  • Excellent telephone etiquette
  • Strong team player
  • Basic computer proficiency
  • Experience in obtaining prior authorizations for infusions
  • Experience in a Rheumatology medical office is preferred



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