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University of Florida · 2 days ago

Clinical Financial Counselor (Oral Pathology)

Gainesville, FL

Full-time

Onsite

Entry Level

$21.63/hr - $26.44/hr

1+ years exp

The University of Florida is seeking a Clinical Financial Counselor for the Department of Oral and Maxillofacial and Diagnostic Science, Division of Oral Pathology. The role involves accurate billing of Pathology procedures, managing insurance claims, and ensuring compliance with financial documentation and processes.

Higher Education

No H1B

Responsibilities

Ensure the accurate billing of Pathology procedures internally and externally

Contact pathology patients daily to obtain a copy of the patient’s insurance card and complete all forms required by third-party billing

Input insurance information into the computer system to ensure correct billing for treatment provided

Use an organized system for tracking and managing insurance claims and to do EOB follow-up

Review accounts receivable for the Pathology Department and perform follow-up on delinquent accounts, according to established policies and procedures, including but not limited to: addressing outstanding receivables, review accuracy of payers, send payment notices and collections letters to patients over 120 days, assist patients with payment options and send collections list to Business Office

Keep all documentation relating to insurance and financial responsibility until all balances are charged and paid in full in accordance with state, federal and agency guidelines

Create and maintain master database for PECOS (providers denied as not ordering and referring providers by Medicare). Collate report for denied providers weekly

Verify personal NPI’s through NPPES and submit letters to new denied providers from the weekly report. Follow-up with providers’ office on status of credentialing via emails and phone calls. Track status of credentialing of providers in CMS.Data.gov after receiving submission confirmation. Provide necessary educational information on credentialing through the Part D Enrollment portal

Assist and provide one-on-one live support and answer questions on the Part D Enrollment portal. Rebill claims from credentialed providers within the timely filing limit and with the provider’s effective dates. Provide and facilitate information to CMS and First Coast Options (MAC) as needed

Assist medical transcriptionists with tops as needed to ensure continuous workflow

Answer calls from Pathology’s external providers and assist in procuring slide requests

Collect payments over the phone. Reconcile external accounts and keep current. Ensure the accurate billing of internal Radiology procedures for FORS/OMFS and Implant Center clinics

Reconciliation of radiology requests with missing charges reports and daily sign-in sheets. Maintain Radiology accounting databases as needed

Ensure timely insurance verification of patients. Monitor the seeking authorization for all procedures. Communicate with various insurance companies which require pre-determination of benefits for comprehensive treatment or when required by a specific insurance carrier

Review and instruct correction of all incorrect patient demographics. Ensure accuracy of all appropriate ICD-10 codes and CPT codes for procedures

Research, review and correct both unpaid self-pay and insurance claims. Re-submit secondary claims to secondary payers

Ensure the posting of charges for procedures and the billing of all claims for Oral Medicine

Assist with obtaining authorization for procedures and input insurance information into the computer system to ensure correct billing for treatment provided

Use an organized system for tracking and managing insurance claims and to do EOB follow-up. Review accounts receivable for the Oral Department and perform follow-up on delinquent accounts, according to established policies and procedures

Qualification

CPC certificationCCA certificationCCS certificationMedical terminologyDental terminologyCustomer serviceData accuracy reviewOrganizational skillsCommunication skills

Required

High school diploma or equivalent and one year of related experience and/or training, including customer service; or an equivalent combination of education and experience