Behavioral Health Benefit Counselor

At Bristol Health, we begin each day caring today for your tomorrow. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet ® and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.
 

Performs a variety of benefit counseling, accounting, clerical and related tasks to enhance the smooth handling of financial arrangements for all patients. Confers with patients and/or guarantors to explain their insurance coverage and limitations, recommends adjustments to accounts according to regulatory agency requirements and hospital sliding fee scales.
 

Essential Job Functions and Responsibilities:

Works with insurance carriers

• Checks and verifies insurance coverage for all patients.
• Telephones insurance carriers and/or uses insurance carrier portals to submit required pre-certification and authorizations.
• Contacts referral sources and other appropriate agencies to secure required information on patients.
• Tracking of authorization expiration dates/units and performs follow-up necessary for re-certifications when required.
• Re-verifies benefits/coverage on yearly basis for all patients.  
• Maintains spreadsheets in order to ensure proper tracking/organization of data.
• Works on problem accounts in a timely manner. 
   

Works with patients

• Conducts counseling with patients, in a professional manner, to educate them on benefit and payment issues in order to secure payment for services rendered.
• Always maintains the confidentiality of patients and their information.
• Performs all calculations of patient fees and completes all payment agreement forms.
   

 Performs documentation and billing duties

• Enters all data of all appropriate information on to the in-house computer system.
• Performs billing and follow-up functions as required.
• Works closely with billing department to resolve account issues in order to ensure proper billing. 
• Identifies accounts needing appeals as it pertains to authorization denials and gathers the necessary information for the Supervisor-Office Manager. 
   

Performs miscellaneous duties

• Reviews outstanding accounts and takes appropriate action for collection of funds.
• Investigates any and all problems relating to financial matters as they pertain to patient accounts. Brings any unusual circumstances to the attention of the Supervisor – Office Manager.
• Upon request, gathers and completes designated statistical and financial information for special report or projects.
• Collect/review all clinical OP/IOP paperwork in order to secure authorizations/re-certifications..
• Work with clinicians and physicians to assure completeness of orders/paperwork prior to patient appointment.
• Register patients in system.   
• Schedule appointments; filing as required.
• Must be willing to be floated or reassigned to another department, unit, office, or location as needed.  
   

Assists in coverage of front desk duties as required

Educational / Minimum Requirements:

High school graduate.

Two years of health care billing.

State/Federal Mandated Licensure or Certification Requirements:

None.

Bristol Hospital Mandated Educational Requirements:

General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

None.

Physical Requirements:

Must maintain flexibility including but not limited to sitting and standing.  Requires continued use of computer screen access and data input requiring dexterity and movement.  Ability to efficiently move about office to seek and retrieve information necessary for decision making.  Vision and hearing corrected to normal is essential.

Work Environment:

Normal office conditions with exposure to patient and Behavioral Health clinical elements. Some exposure to emergency situations within department.

Cognitive Requirements:

Must be able to think independently, analyze information, execute written and oral instructions, follow directions, speak, write and understand English and have good mathematical aptitude.  Excellent communication skills required. Ability to handle sensistive information and maintain patient confidentiality. Must be able to work independently and handle time sensitive tasks. Experience with Google products/Excel spreadsheets beneficial. 

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.