Financial Counselor

Trinity Health•Grove City, OH

24d•Onsite

About The Position

The Patient Financial Specialist II obtains demographic, clinical, financial and insurance information in the process of appointment making for patient tests and procedures. In addition, the PFS II also performs pre-registration and registration activities including response to real-time eligibility verification and financial clearance. Incumbent provides instructions to the patient on test preparation, prints and mails patient itineraries if lead time is sufficient and validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Obtains and processes signed physician orders to ensure clinical documentation for care delivery.

Requirements

High School Diploma
Must possess a working knowledge of medical terminology, and data entry skills.
Effective communication skills
Excellent interpersonal skills are necessary in dealing with peers, internal, and external customers.
Accuracy, attentiveness to detail and time management skills are required.
Incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively.

Responsibilities

Performs activities that relate to patient scheduling, pre-registration, registration, real-time eligibility verification, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other intradepartmental functions.
Determines proper scheduling requirements and/or limitations according to requested test(s)/procedure(s) and scheduling resources (equipment, staff, room, and etc.) in a timely manner to ensure customer satisfaction, maintain patient flow, and appropriate utilization of the service area. Coordinates add-on and same-day appointments with the service area, as required. Ensures proper test sequencing with minimal patient delays when multiple testing is required.
Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions. Communicates with various ancillary departments to ensure an accurate schedule and that all reports are properly distributed.
Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).
Obtains signed physician orders for all tests and procedures from physicians/offices for testing and procedures or advises patient they must present a physician’s order on the date of service.