Financial Counselor (F/T) - Remote

Optim Health System is seeking (2) full time Financial Counselor. This is a remote position. 

Job Requirements:

 Primary Duties: - Conduct thorough financial consultations with pre-surgical patients to review insurance
benefits, out-of-pocket costs, and payment expectations.
- Verify insurance eligibility, benefits, deductibles, and out-of-pocket maximums for surgical
procedures.
- Provide cost estimates for procedures and ensure patients understand their financial
responsibility before surgery.
- Assist with obtaining prior authorizations and securing approvals for surgical procedures.
- Discuss payment plan options and financial assistance programs for patients with high
out-of-pocket costs.
- Ensure patients understand their benefit plan and payment obligations, including any
facility charges.
General Financial Counseling:
- Educate patients on insurance coverage, copayments, deductibles, and other financial
obligations.
- Review and address patient billing inquiries and resolve concerns regarding charges,
payments, and statements.
- Coordinate with the billing department to ensure accurate patient financial records and
address discrepancies.
- Assist patients in completing financial assistance applications, setting up payment
arrangements, and accessing available resources.
- Provide guidance on self-pay options, discounts, and third-party financing when
necessary.
Revenue Cycle & Compliance:
- Ensure compliance with federal, state, and practice-specific financial policies and
procedures.
- Work closely with physicians, surgery schedulers, and the billing department to streamline
financial clearance for procedures.
- Maintain documentation of patient financial discussions and agreements in the electronic
health record (EHR) system.
- Stay updated on changes in healthcare insurance policies, reimbursement trends, and
financial assistance programs.
Claims Processing & Coordination of Benefits:
- Review outstanding balances and contact patients regarding payment prior to their visit.
- Validate in-network and out-of-network status for providers and facilities.
- Coordinate with insurance carriers on any claims discrepancies or coordination of benefits
(COB) issues.
- Assist in claim resolution by verifying patient coverage and addressing any outstanding
COB issues.
Pre-Bill Coding Reviews:
- Validate ICD-10 codes used and order on each CPT code line.
- Ensure proper utilization of evaluation and management (E&M) codes and in-office
procedure codes.
- Review visit type, modifier application, laterality, and medication unit verification for
injections

Optim Offers:   

• Competitive Pay  
• Company Benefits  
• Vacation, Personal, and Sick Time Off  
• Holiday Pay  
• 401K Plan