Financial Counselor

Job Overview:

The Financial Counselor position supports the billing and collection process for the clinic, infusion and business operations at Cancer Institute to ensure maximum reimbursement. Verifies insurance eligibility, coverage, deductibles and co-payments. Counsels patients about their health care benefits and financial responsibilities. Responsible for obtaining insurance pre-certification and prior authorization for services. Submits appeals of coverage denials. Screens and assists the uninsured and underinsured in obtaining public benefits, charity care, or other financial sponsorship. Enters and updates patient insurance and demographic information in appropriate system(s). Contributes to the research mission and participates in performance improvement activities in order to improve the quality, consistency, and efficiency of services provided. Position requires interaction and competency in providing care to patients in all age categories from neonates through geriatrics and all populations.

Qualifications:

Required:

• Three (3) years experience in a physician s office, hospital, or clinic or with a health insurance company working with patient benefits and financial information and/or customer service
• General medical terminology or knowledge of oncology medical terminology
• Knowledge of CPT and ICD-10 coding and Medicare, Medicaid, and other medical insurance coverage
• Highly effective oral and written communication skills are required to communicate with clinical, administrative and other personnel
• Superior interpersonal skills are important in maintaining a sound public image in dealing with patients, families, physicians and insurance companies
• Excellent critical thinking and attention to detail required
• Must be computer literate with proficiency and working knowledge of databases and reporting tools such as MicrosoftWord and Excel, Access and PowerPoint
• Must demonstrate an understanding of the principles of guest relations and be able to maintain a professional demeanor and customer service orientation under busy and stressful situations

Preferred:

• Prior experience with computerized billing systems preferred

Scheduling Requirements:

• Evening Shift
• Full-Time

Essential Functions:

• Obtaining authorization from insurance companies for patient procedures as follows:
  • Clinic visits and procedures
  • Outpatient services and chemotherapy
  • Other emergency admissions
  • Ancillary Testing
• Obtains approvals from insurance companies when required to ensure insurance coverage for patients professional visits and treatments. Updates insurance companies with concurrent review of information as necessary to obtain referrals or ensure reimbursement. Documents in appropriate billing systems
• Coordinates with the physician or nurse as needed to obtain clinical information. Retrieves information from patient medical record to complete requests
• Submits appeals of insurance denials in collaboration with the attending physician.
• Assists patients to understand the issues of health care finance

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered, high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.