Req ID: 22594
Employment Status: AF - Active
This is a position requiring professional phone skills, independent thinking, and advanced insurance/registration techniques. The Financial Counselor will be responsible for outpatient procedures as well as complex procedures to optimize patient flow and resource utilization.
The Financial Counselor will also answer calls, handle verification and identification of covered and non-covered services, explanations of benefits structures, as well as necessary follow-up with families, providers, and payors regarding: referral issues, authorization questions, FHCC eligibility as well as a host of other insurance eligibility issues. The Financial Counselor will cross cover other areas as needed.
Demonstrates an understanding and provides information of benefit structures to patients, physicians, and hospital practices as well as provides information on the following areas:
Hospital prompt pay and payment plan policies
Process for pre-cert/pre-auth of non covered services
Provide ID numbers & CPT codes (if applicable)
Verify coverage & benefit information via electronic eligibility or by contacting payor
Follows up with insurance companies and families of patients identified as ineligible or non-covered
Contacts family and/or responsible party, as necessary, to inform them of any insurance problems or restrictions, ensuring that insurance information is clearly relayed to and understood by family and/or responsible party. Contact clinical office with all information that requires follow-up.
Assist with FHCC issues
Completes abbreviated assessment to determine family eligibility for Family Health Care Coverage programs.
Create and/or update patient record by verifying demographic, insurance information, or proper study identification in the registration system
Ensure specific registration fields are accurately inputted into registration system, including but not limited to visit notes, referral/authorization numbers, eligibility review, proper payor plan entries for research and standard-of-care visits
Verify coverage through Emdeon/Navinet/Passport, etc. and pull appropriate referrals.
Coordinate & communicate insurance issues with appropriate personnel (e.g. schedulers, Pre-cert dept, out-of area dept, Self-Pay group, etc )
Educate and inform family of outstanding financial obligations if appropriate.
Electronically collect or facilitate payment of outstanding balances
Job Responsibilities (Continued)
Job Responsibilities (Continued)
Required Licenses, Certifications, Registrations
Required Education and Experience
High school diploma required
2 years registration experience required
Medical Insurance Background required
Strong Customer Service experience required
Preferred Education, Experience & Cert/Lic
Bachelors Degree preferred.
EPIC registration experience preferred
Resource scheduling experience preferred (e.g. ancillary testing)
Background in medical terminology preferred
Additional Technical Requirements
Ability to work with stressful situations
Ability to function efficiently and professionally with minimum of supervision.
Ability to quickly learn new procedures.
Strong computer skills.
Ability to juggle multiple insurance issues.
Strong customer service skills
Ability to display compassion and empathy
Mandatory required training within first 30 days:
ACD Software Training
Website Insurance Training (Navinet, WebMD, Passport)
EPIC training & testing (Prelude/Cadence).
Cardiac Center databases
All CHOP employees who work in a patient building or who provide patient care are required to receive an annual influenza vaccine unless they are granted a medical or religious exemption.
Children's Hospital of Philadelphia is committed to providing a safe and healthy environment for its patients, family members, visitors and employees. In an effort to achieve this goal, employment at Children's Hospital of Philadelphia, other than for positions with regularly scheduled hours in New Jersey, is contingent upon an attestation that the job applicant does not use tobacco products or nicotine in any form and a negative nicotine screen (the latter occurs after a job offer).
Children's Hospital of Philadelphia is an equal opportunity employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, age, religion, national or ethnic origin, disability or protected veteran status.
VEVRAA Federal Contractor/Seeking priority referrals for protected veterans. Please contact our hiring official with any referrals or questions.
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2716 South Street, 6th Floor
Philadelphia, PA 19146
The Children S Hospital Of Philadelphia