Financial Counselor

Lexington Health; Columbia (SC); On-site; USD 35,000 - 52,000; Full time

Benefits offered by this job

Day 1 benefits

FSAs (Flexible Spending Accounts)

403(b) match

Life insurance

Job summary

Lexington Health in Columbia, SC is seeking a full-time Insurance Benefits Counselor to advise patients on coverage and payment options. You will establish financial arrangements in line with insurance carriers and our policies, aiming to improve reimbursement and reduce A/R days.

Responsibilities include documenting cooperation with billing, verifying eligibility, communicating with payors, and ensuring compliance with HCFA ICD/CPT guidelines. Prior billing experience preferred.

Qualifications

• Minimum education: High School Diploma or equivalent.
• Minimum 6 months of insurance/billing experience in healthcare.
• Extensive knowledge of medical terminology, HCFA 1500, ICD10, and CPT coding.

Responsibilities

• Assist with benefit coordination to assure financial obligation is met promptly.
• Identify billing issues and coordinate with physicians and managers on reimbursement rates.
• Stay current on Governmental Reimbursement programs to support leadership on related matters.
• Prepare financial statements and establish payment arrangements prior to procedures to maintain A/R goals.
• Verify documentation from payors for clean claims.
• Communicate with CBO on appeals and claims processing.
• Post patient payments and assist with posting insurance payments.

Skills

Insurance benefits knowledge

Financial counseling

Communication skills

Healthcare billing

Education

High School Diploma or equivalent

Job description

Lexington Oncology

Full Time

Day Shift

8:00am-4:30pm Mon-Fri

Lexington Health is a comprehensive network of care that includes six community medical and urgent care centers, nearly 80 physician practices, more than 9,000 health care professionals and Lexington Medical Center, a 607-bed teaching hospital in West Columbia, South Carolina. It was selected by Modern Healthcare as one of the Best Places to Work in Healthcare and was first in the state to achieve Magnet with Distinction status for excellence in nursing care. Consistently ranked as best in the Columbia Metro area by U.S. News & World Report, Lexington Health delivers more than 4,000 babies each year, performs more than 34,000 surgeries annually and is the region's third largest employer.

Lexington Health also includes an accredited Cancer Center of Excellence, the state's first HeartCARE Center, the largest skilled nursing facility in the Carolinas, and an Alzheimer's care center. Its postgraduate medical education programs include family medicine and transitional year residencies, as well as an informatics fellowship.

Job Summary

Responsible for counseling patients regarding their insurance benefits; with accountability for collecting and/or establishing financial payment arrangements to adhere to LMC policy regarding the financial responsibility according to insurance carrier and/or self-pay obligations in order to have a positive financial impact on the practice. Interprets and applies compliance guidelines to maintain billing integrity.

Minimum Qualifications

Minimum Education: High School Diploma or Equivalent

Minimum Years of Experience: 6 months insurance experience in a healthcare setting

Substitutable Education & Experience: None.

Required Certifications/Licensure: None.

Required Training: Procedural knowledge of commercial, Medicaid, Medicare, Workers' Compensation, all contractual third party payers, other private carriers, billing, reimbursement, and regulatory compliance; Extensive knowledge of medical terminology, HCFA 1500, ICD10, and CPT coding.

Essential Functions

• Works independently but closely with manager and operations director or division administrator.
• Assist patient with benefit coordination to assure the appropriate financial obligation and responsibility is met in a timely manner.
• Identify potential billing issues and act to resolve those problems quickly, and work collaboratively with physicians and managers regarding effectiveness in reimbursement rates, billing and collection.
• Expectation is to stay current on all Governmental Reimbursement programs in order to provide assistance and guidance to leadership on reimbursement-related matters within the LMC contractual agreements.
• Accurately prepare financial payment statements outlining benefits and collect appropriate funds and/or establish payment arrangements prior to date of surgery to maintain A/R days within set goals, as required.
• Obtain and verify appropriate documentation from payor to establish coordination for clean claims.
• Communicates with the CBO to assist as appropriate in the writing of appeals for denied claims and follow up on claims processing.
• Assist CBO staff with accounts and reviews invoices for accuracy and completeness as deemed appropriate.
• As requested, calculate estimates for visits, procedures, and/or surgeries, electronically managing records of estimates provided.
• Verifies accuracy and correct use of ICD10 and CPT coding.
• Compliance with carrier's policies.

Duties & Responsibilities

• Post patient payments and assist with posting insurance payments, as deemed appropriate.
• Research and follow-up on denials, claim corrections and rejections, as requested.
• Provides accurate interpretation of EOBs, bulletins, advisories, fee schedules, payor guidelines, regulations and all other pertinent information.
• Provides education to all office staff regarding financial counseling.
• Assists patient, office staff, and insurance companies regarding claims, payments, adjustments, referrals and pre-certifications.
• Maintains all informational material received from insurance companies, documenting all information within account notes.
• Responsible for maintaining billing integrity: Fraudulent or abusive billing practices, (i.e., duplicate billing, overstating charges, etc.). Any exceptions should be brought to the immediate attention of the manager.
• Demonstrates knowledge of commercial, Medicaid, Medicare, Workers Compensation, all contractual third party payors and other private carriers.
• Prepares and runs reports on a daily, weekly, monthly basis or as deemed appropriate.
• Helps maintain the work area in a neat and orderly fashion. Responsible for keeping supplies needed to perform the job duties.
• Demonstrates appropriate communication of information to all ages and responds to all customers/ patients requests and needs, i.e., hard of hearing, etc.
• Respond to customer inquiries, complaints and correspondence in a prompt and professional manner to conform to LMC's Service Excellence guidelines and LMC's corporate compliance.
• Performs all other duties as assigned.

We are committed to offering quality, cost-effective benefits choices for our benefit eligible employees and their families:

• Day ONE medical, dental and life insurance benefits
• Health care and dependent care flexible spending accounts (FSAs)
• Employees are eligible for enrollment into the 403(b) match plan day one. LHI matches dollar for dollar up to 6%.
• Employer paid life insurance - equal to 1x salary
• Employee may elect supplemental life insurance with low cost premiums up to 3x salary
• Adoption assistance
• LHI provides its full-time employees employer paid short-term disability and long-term disability coverage after 90 days of eligible employment
• Tuition reimbursement
• Student loan forgiveness

Equal Opportunity Employer

It is the policy of Lexington Health to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. Lexington Health strives to provide a discrimination‑free environment, and to recruit, select, on‑board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. Lexington Health endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee’s desires and abilities and the hospital’s needs.

Nearest Major Market:

Columbia

Nearest Secondary Market:

South Carolina