Patient Health Benefits Counselor

CommonSpirit Health; Centennial (CO); Remote; USD 29,000 - 44,000; Full time

Job summary

CommonSpirit Health is seeking a Patient Health Benefits Counselor to verify benefits, determine patient qualification for CICP or charity programs, and arrange payment plans while ensuring proper authorization for procedures.

In this remote role, you will collaborate with patients, physicians, clinics, and billing teams; you will document accurately, screen for eligibility, obtain pre-certifications, and collect patient portions per insurance.

Qualifications

• High School Diploma or GED required.
• Six (6) months healthcare experience.
• Knowledge of ICD-10 and CPT coding.
• Medical terminology with good customer service skills.

Responsibilities

• Document electronically on account information and update in a timely manner.
• Screen self-pay patients to determine eligibility for CICP, charity programs, or payment arrangements.
• Obtains pre-certification and benefits from insurance for admissions to comply with carrier rules.
• Act as hospital liaison between insurance companies, case managers, central business office, and billing/eligibility entities.
• Must demonstrate and maintain knowledge of registration pathways.
• Collects patient portion as determined by the patient''s insurance.

Skills

Analytical skills

Benefit verification

Communication

Negotiation

Insurance processes

Medical terminology

Education

High School Diploma or GED

Tools

ICD-10 coding

CPT coding

Job description

Job Summary And Responsibilities

As our Patient Health Benefits Counselor, you will make policy-supported decisions based on confidential financial information to determine patient qualification for Countermeasures Injury Compensation Program (CICP), Charity programs, or payment arrangements, while also verifying coverage and authorization for all scheduled procedures.

Every day you will utilize scheduling and registration information to confirm benefits, populate price estimate tools to determine patient portions, obtain necessary authorizations, collect payments, and serve as a crucial liaison between patients, physicians, clinics, case management, and various billing/eligibility entities.

To be successful in this role, you will possess strong analytical skills for financial assessment, meticulous attention to detail in benefit verification and authorization, excellent communication and negotiation abilities for patient counseling and payment collection, and a deep understanding of patient financial programs and insurance processes.

• Demonstrates accurate documentation electronically on account information and updates in a timely manner.
• Screens self-pay patients to determine eligibility for CICP (as applicable), charity programs, or payment arrangements.
• Obtains pre-certification and benefits from insurance companies for the admission or expected admission of a patient to comply with the rules and regulations of the patient's insurance carrier.
• Acts as hospital liaison between insurance companies, case managers, central business office, third party Medicaid eligibility vendor, and registration.
• Must demonstrate and maintain knowledge of registration pathways.
• Collects patient portion as determined by the patient's insurance.

This position is 100% remote. Must live in either Utah or Colorado.

Job Requirements

• High School Diploma or GED
• Six (6) months healthcare experience
• Knowledge of ICD 10 and CPT coding
• Medical terminology with good customer service skills

Preferred

• Knowledge of registration and billing and credit scoring
• CPR Certification (as required by facility)

Where You'll Work

With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Pay Range

$20.46 - $31.71 /hour