About The Position

The Financial Counselor is an advanced level position and is expected to have a high level of proficiency in all department duties and be proficient to fill in on an interim basis in any department within admissions with minimal refresher training. Facilitates patient access to Cedars Sinai Medical Center and secures all demographic and financial patient registration information. This will include the following: Registration, Pre-Registration, insurance verification, Third Party Liability (TPL) screening, Medi-Cal/Medicare eligibility verification, Workers Compensation eligibility, and securing cash deposits (co-pays, deductibles, cash packages). Able to explain information and answer questions.

Requirements

  • High level of proficiency in all department duties
  • Proficient to fill in on an interim basis in any department within admissions with minimal refresher training
  • Proficient in registration, pre-registration, insurance verification, Third Party Liability (TPL) screening, Medi-Cal/Medicare eligibility verification, Workers Compensation eligibility, and securing cash deposits (co-pays, deductibles, cash packages)
  • Able to explain information and answer questions
  • Proficient in performing insurance verification electronically, telephonically, Direct Data Entry (DDE) or product website use on Medicare, Medicaid, HMO, PPO or commercial products
  • Proficient in performing accurate system search to secure a medical record number or assign a new one without duplication
  • Proficient in accurate selection of physician
  • Knowledgeable about privileging issues (physician suspensions) and how to handle and resolve them
  • Strong patient interviewing skills
  • Ability to interact with patients and perform job duties with sensitivity and attention to the patient population(s) being served
  • Proficient to independently handle routine/frequent inquiries from patients, patient representatives and insurance companies
  • Demonstrates collection skills
  • Able to determine and explain patient financial obligation (deductibles)
  • Proficient in navigating and entering patient and financial information in the hospital management system and associated systems
  • Ability to compile reports upon request through all available resources
  • Competent in ALL areas of their registration area and demonstrates the ability to assist anywhere in their respective department
  • Knowledgeable and adheres to state, federal and regulatory requirements, and CSMDRH policy specific to the admissions department
  • Adept at accurately reviewing physicians' orders, progress notes and general clinical data required to initiate prior authorization requests with insurance provider
  • Proficient in informing patient of expected out of pocket cost regarding patient responsibility, following established scripting
  • Proficient in performing all schedule related activities to include: scheduling, rescheduling and cancellation of appointments
  • Proficient in screening and prioritizing scheduling calls and appointments
  • Proficient in notifying patient of any necessary documentation to include: valid insurance card, photo ID and form of payment
  • Proficient in notifying patient of any required preps prior to scheduled visit

Nice To Haves

  • Consideration for super user status
  • Ability to meet or exceed cash collection goals

Responsibilities

  • Performs all admissions activities for pre-admit and face-to-face registration of patients presenting to the main admissions and/or outpatient areas for treatment.
  • Acquires financial clearance and determines patient's correct financial classification. Performs insurance verification electronically, telephonically, Direct Data Entry (DDE) or product website use on Medicare, Medicaid, HMO, PPO or commercial products.
  • Performs accurate system search to secure a medical record number or assign a new one without duplication.
  • Performs accurate selection of physician. Recognizes privileging issues (physician suspensions). Knows how to handle and resolve physician privilege and suspension issues.
  • Demonstrates strong patient interviewing skills. Interacts with patients and performs job duties with sensitivity and attention to the patient population(s) being served.
  • Proficient to independently handle routine/frequent inquiries from patients, patient representatives and insurance companies. Escalates issues appropriately.
  • Demonstrates collection skills. Able to determine and explain patient financial obligation (deductibles). Meets or exceeds cash collection goals.
  • Interacts with physicians and specialty departments to assure accurate intake of information required for registration and account adjustments.
  • Demonstrates proficiency regarding navigation and entering patient and financial information in the hospital management system and associated systems. Demonstrates skill level allowing consideration for super user status.
  • Demonstrates the ability to compile reports upon request through all available resources.
  • Clears work lists daily and assists others when necessary.
  • Is competent in ALL areas of their registration area and demonstrates the ability to assist anywhere in their respective department.
  • Productivity requirement: Completes no less than 30 registrations per shift on average. (may vary by admissions area)
  • Productivity requirement: Handles no less than 10 inquiries per day from patients, physicians, family members and internal staff.
  • Knows and adheres to state, federal and regulatory requirements, and CSMDRH policy specific to the admissions department.
  • Provides correct questionnaires for related exams.
  • Provides correct cash package for visits and exams.
  • Screens and prioritizes requests, manage Work Queues (WQs) and workload in an efficient manner, route inquiries to other levels as appropriate and follow up with patient and/or clinic with status of authorization.
  • Adept at accurately reviewing physicians' orders, progress notes and general clinical data required to initiate prior authorization requests with insurance provider.
  • Informs patient of expected out of pocket cost regarding patient responsibility, following established scripting. This includes reviewing payment options when authorization is denied.
  • Performs all schedule related activities to include: scheduling, rescheduling and cancellation of appointments.
  • Screens and prioritizes scheduling calls and appointments. Triage calls to other areas within the organization as appropriate.
  • Notifies patient of any necessary documentation to include: valid insurance card, photo ID and form of payment.
  • Notifies patient of any required preps prior to scheduled visit.
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