Clinical Financial Counselor (Oral Surgery)

Oral Surgery•Gainesville, FL

9h•Onsite

About The Position

The Clinical Financial Counselor is responsible for scheduling and coordinating care with associated services at UF Health Shands, including the scheduling and pre-certification of all OR surgeries. This involves coordinating history and physical, pre-orthognathic work-up, and pre-surgical anesthesia appointments, as well as diagnostic testing like MRI and CT scans. The role also includes posting OR cases on the SNAP board and updating faculty Outlook calendars. As a financial counselor, the incumbent will interview and counsel patients in Oral and Maxillofacial Surgery and the Center for Implant Dentistry to determine financial status and insurance coverage. This includes verifying insurance, determining covered/non-covered services, updating account information, printing treatment plans, handling electronic billing, and printing dental claim forms. They will enter treatment plans and charges into the system, communicate with insurance companies for surgery authorization approvals, and work with Medicaid Portals for direct billing. The counselor will determine HMO, PPO, or Worker’s Compensation coverage, ensure pre-certification, and verify patient insurance details on platforms like Availity and MMA Medicaid plans to ascertain deductibles, co-payments, and extent of coverage. They are responsible for notifying patients, students, residents, and faculty about financial obligations and authorized services, ensuring treatment plans adhere to agency guidelines. Additional duties include gathering insurance card copies, completing third-party payer forms, inputting insurance information for correct billing, creating medical record numbers in the UF Health Shands Epic scheduling network, and emailing residents CPT/DX codes and surgery dates for Epic encounters. The role also involves answering OMFS Financial Office phone lines, assisting callers with financial questions, and supporting department insurance explanation of benefits review, claims filing, and adjustment/refund requests.

Requirements

High school diploma or equivalent.
One year of related experience and/or training, including customer service.
An equivalent combination of education and experience.

Nice To Haves

Knowledge of general office procedures and practices.
Working knowledge of basic math.
Able to plan, organize and coordinate work activities.
Able to follow instructions, written and verbal.
Able to communicate effectively.
Able to establish and maintain effective working relationship with others.
Able to review data for accuracy and completeness.
Knowledge of dental and medical terminology (basic terms at least).

Responsibilities

Arranges the coordination of care with associated services at UF Health Shands, including the scheduling and pre-certification of all OR surgeries.
Coordinates scheduling history and physical, pre-orthognathic work-up, and pre-surgical anesthesia appointments.
Schedules history and physical, pre-orthognathic workup appointments, diagnostic testing (MRI, CT scan, etc.) for both clinical and hospital grade requests.
Posts OR cases on the SNAP board.
Updates the faculty Outlook calendars with OR cases.
Interviews and counsels patients who will or have been treated in Oral and Maxillofacial Surgery and Center for Implant Dentistry to determine financial status and/or insurance coverage.
Verifies insurance coverage for each patient and determines if services to be provided are covered and/or non-covered according to individual insurance policies.
Verifies account information in our computer system to ensure accuracy and update accounts as necessary.
Prints proposal treatment plans for patients.
Handles knowledge of electronic billing and prints dental claim forms.
Enters treatment plans and charges into the system.
Communicates with various insurance companies to obtain all inpatient and outpatient surgery authorization approvals.
Works with Medicaid Portals for direct billing of all Medicaid dental or medical billing for the department.
Determines patients who are covered by HMO, PPO, or Worker’s Compensation.
Ensures that each HMO, PPO or Worker’s Compensation visit is pre-certified.
Verifies patient’s insurance information on Availity, MMA Medicaid plans, and commercial plans.
Determines deductible, co-payment and extent of coverage.
Notifies patients of any deductibles due and/or any co-payment not covered by their policy.
Notifies students, residents, and faculty of services which are authorized and monitors treatment plan to ensure that all procedures are performed according to agency guidelines.
Notifies students, residents and faculty of the amount of payment to be collected from the patient prior to treatment being provided.
Gathers and verifies copies of the patient’s insurance card and completes all forms required by third party payers.
Inputs insurance information into the computer system to ensure correct billing for treatment provided.
Creates medical record number for dental patient in the UF Health Shands Epic scheduling network system.
Emails residents the CPT codes, DX codes, and surgery dates to enter an Epic encounter to create the OR case.
Answers OMFS Financial Office phone lines.
Assists callers with financial questions regarding their accounts with both the oral surgery resident clinic and implant center (as needed).
Assists with department insurance explanation of benefits review for posting accuracy, providing requested information timely and efficiently, claims filing in Inovalon, submitting adjustment and refund requests, as needed.

Benefits

Low-cost State Health plans.
A number of Dental plans to fit you and your family’s needs.
Vision insurance.
Domestic partner coverage through GatorCare.
Optional plans such as life, disability, legal and accident insurance.
Competitive pension plans.
Investment accounts.
Voluntary add-ons, such as 457 deferred compensation and 403(b) plans.
Variety of leave programs including vacation, sick leave, 11 paid holidays, personal leave days, and family medical leave.
TEAMS employees accrue approximately 22 vacation days annually.
TEAMS employees accrue 13 sick days annually.
TEAMS employees accrue 4 personal leave days, typically used during the holiday closing period (accruals based on full-time employment).
Paid family leave (eight full weeks of leave over a 24-month period).
GatorPerks Discount Program.