Site: FMCOH Wiregrass Ranch Hospital

Location: Wesley Chapel, Florida
Position: Financial Counselor Lead 

Department: Patient Access - ER & Outpatient Registration
Shift: 7:00am-3:30pm

Elevating Healthcare in Wesley Chapel and West Florida, Florida Medical Clinic Orlando Health Wiregrass Ranch Hospital is poised to revolutionize healthcare in Wesley Chapel and the broader West Florida region. This five-story, state-of-the-art multi-specialty hospital spans 380,000 square feet, purpose-built to serve one of Florida’s fastest-growing communities with exceptional, outcomes-focused care.

Designed for Excellence:

• Opening with 102 beds, expandable to 300 beds at full build-out
• 9 advanced operating rooms, including a hybrid OR with real-time imaging capabilities
• Comprehensive services in cardiology, neurology, oncology, surgery, and more

From life-saving procedures to advanced diagnostics, this facility is engineered to meet the evolving needs of our community with precision and compassion.

Job Summary

The Financial Counselor Lead is a key position on the team which assists patients and their families with a host of services to ensure that the process of collection payments is fully explained and is as comfortable as possible.

Essential Functions

• Understands the importance Orlando Health places on providing exemplary customer service and performs job functions in a manner that helps meet the department customer service goals.
• Demonstrates a positive and professional approach and communicates effectively with customers and team members at all times.
• Identifies customer service issues and resolves or initiates necessary follow-up. Implements service recovery efforts as appropriate.
• Efficiently and accurately gathers and inputs patient/guarantor demographic and financial information
• Explains necessary forms and obtains signatures from patient/guarantor.
• Contacts appropriate payers, verifying benefits and obtaining necessary authorizations.
• Utilizes appropriate reports to contact insurance payers for resolution to accounts that are pending, denied or in the appeal process.
• Explains insurance benefits and collects co-pays, deductibles and self-pay portions due.
• Collects for related professional care as appropriate.
• Collects outstanding balances due from previous accounts or establishes payment arrangements for these balances as appropriate.
• Provide complete resolution to patients billing issues and questions.
• Contacts Primary Care or Admitting Physician to obtain authorizations, diagnosis, and procedure detail as necessary.
• Documents authorization and benefit information in registration system.
• Assembles patient record and obtains copies of relevant documents including insurance cards, photo identification cards and any advance directives.
• Demonstrates a thorough knowledge of third party reimbursement requirements and regulations.
• Exhibits thorough knowledge in the use of all registration and scheduling systems, electronic verification tools and Web based resources.
• Follows Patient Financial Services self-pay policies including completion of Guarantor Financial Statement Application, explanation of payment options and collections of monies due.
• Screens patient/guarantor for federal, state, county or other assistance programs and completes necessary forms and applications per facility guidelines.
• Follows Patient Financial Services policies related to cash handling.
• Performs departmental cashiering functions and process point of service transactions.
• Performs advanced department cashiering functions.
• Collects and inventories patient valuables following policy guidelines.
• Maintains thorough understanding of the medical necessity screening process and appropriate systems.
• Maintains a thorough knowledge of ICD-10 and CPT codes.
• Performs appropriate pre-registration functions including calling physician offices, insurance payers and the patient/guarantor, as necessary.
• Cross-trained with appropriate knowledge and skills necessary to staff all areas of Patient Access at any facility, including but not limited to Front Desk, Admitting Office, Cashier, Insurance Verification, Floor Representatives, Pre-Registration, Scheduling and Emergency Department Business Office.
• Acts as a resource for training of new team members.
• Serves as a resource during the implementation of new process improvements.
• Performs the duties of a system super user.
• When performing scheduling functions provide patients with thorough and accurate procedure information.
• When performing scheduling functions maintains open communication with physicians and their offices, patients, all ancillary and surgical areas to include scheduling, rescheduling and cancellations of single/multiple tests and procedures.
• Acts as liaison between Nursing, Ancillary, Scheduling, Case Management, Social Workers, Managed Care Companies, Physicians, Administration and Patient Accounting.
• Maintains departmental logs for statistical reporting.
• Works departmental reports as assigned.
• Exhibits thorough knowledge in the use of the telephone system, scanners, printers, copy machine, fax machine, and paging systems.
• Consistently meets Quality Assurance standards set by Patient Access and the department.
• Meets departmental goals regarding collections, productivity and customer service.
• Maintains flexibility in work schedule availability that allows department to change/modify work schedule to meet departmental needs.
• Meets federal, state and hospital requirements related to compliance issues.
• Attends and participates in department staff meetings and attends other meetings as assigned.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.
• Represents and participates in department, facility, Patient Financial Services and corporate committees.
• Responsible for reviewing and adhering to all Patient Financial Services and departmental education initiatives.
• Attends educational opportunities outside of department as directed by management.
• Assists his/her manager in planning and organizing department activities.

Education/Training

• High School or equivalent.
• Must complete Corporate and Patient Financial Services annual educational requirements.

Experience

• Two (2) years’ experience in a financial, business office, or customer service environment.
• Proficient in Windows Microsoft Office-based products (Word, Excel, PowerPoint).
• Typing proficiency.
• One (1) year PC/Windows experience.