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Cleveland Clinic


Independence, OH

Job Category
Health Care-Cleveland Clinic
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Job Title

Fin Counselor, CCHS Employees Only Job

Fin Counselor

CCHS Employees Only
Reference Title
HR Use Only:
Hospital: Main Campus Non-Exempt2
Facility: CC Business Operations Ctr
Department: Care Management
Job Code: U18012
Pay Grade: 9
Schedule: Full Time
Shift: Days
Hours: 9 to 5:30
Job Details: - High School Diploma or equivalent Required.

JOB SUMMARY: Counsels patients and/or parties responsible for payment regarding payment responsibilities and options. Provides support to the Care Management staff, maximizing financial reimbursement. Maintains current knowledge of requirements of payers, manages payor communication and documentation for authorization process. Responsibilities include customer service, communications and follow-up processes for commercial and government payers, insurance verification and account reconciliation.

Job Responsibilities: Conducts payor-specific communications and support for the Care Management team, including direct communication of clinical reviews, monitoring of payor issues, and facilitating necessary retrospective reviews. Tracks and enters authorizations and other benefit information into appropriate electronic systems, such as Allscripts, ADT and EAPM. Participates in central call center, servicing any and all hospitals and payors, verifying information and resolves common problems. Provides necessary verbal and electronic communication to and from case management staff, serving as a liaison between hospital personnel and the various payors. Completes data tracking and collection to assist with the identification of routine statistics and problems and trends, such as turn around time, accuracy of reviews, etc. Participates in early identification of issues that would result in delayed or non-payment of claims and takes a proactive approach to problem resolution. Acts as a resource and superuser for Case Management staff on payor related issues and Allscripts. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experience staff. Explains financial responsibilities for services received, payment options and collection procedures to patients and/or parties responsible for payment. Counsels patients regarding insurance benefits and recommends alternative sources of payment and/or financial assistance when appropriate. Contacts insurance carriers or other sources and acts as an advocate for the patient. Initiates process for collecting prepays due and performs follow-up to insure maximum collection is achieved. Other duties as assigned.

Education: Post-high school coursework in business, finance, accounting, or equivalent work experience in a financial environment to acquire those skills. Bachelor's degree in health-related field preferred.

Licensure/ Certification/ Registration: None required.

Required Experience: Minimum four years previous experience in collection or other related experience with a bank, finance company or in a health care institution. Experience processing medical insurance claims is helpful. Note: An Associate's Degree in Accounting, Finance, or other related field may substitute for up to one year of the stated experience OR a Bachelor's Degree in Accounting, Finance, or related field may substitute for up to two years of stated experience. Critical thinking skills, decisive judgment and the ability to work with minimal supervision preferred. Must be detail-oriented, possess excellent communication, organizational and interpersonal skills. Must be able to multi-task and maintain composure in difficult situations in a fast paced environment. Demonstrates a positive and professional approach and communicates effectively with customers and team members. Ability to use the computer and phone a must.

Category: Finance/Information Systems

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