Clinical Financial Counselor

Determine insurance coverage and financial status of patients for the Restorative Dental Sciences (RDS) Faculty Practice (FP), according to procedures established by the College of Dentistry (COD) and the University of Florida (UF).  Work with patients of RDS FP Care Center both at time of service and through accounts receivable to collect payment. Counsel patients regarding benefits of treatment plans, costs, and financing options.  Process and follow through on third-party payer or agency claims.  Maintain current dental terminology (CDT), and third party payer contract requirements.  Responsible for collecting all balances due through patient contact in person, by telephone, by correspondence, or by working with an outside collection agency.  Produce accounts receivable and other reports for faculty dentists. Perform receptionist and clerical duties related to the practice as needed. Facilitate and coordinate veterans appointments and work with VA and Community Care to gain treatment approvals- RFS and follow up on authorizations consistently to assure approvals are current. Request RFS as needed from VA.

Interview and counsel all patients in the Restorative Dental Sciences, Faculty Practice Care Center to determine their financial status and/or insurance coverage and advise them of available payment options.  Review insurance policies to determine deductible, co-payment, and extent of coverage.  Prepare estimates of dental fees to discuss costs with patients and negotiate payment and collections with insurance companies. Collect balances on patient accounts and ensure accuracy of debits and credits for patient balances.  Assist patients in establishing payment method for proposed treatment before treatment begins (i.e., cash payments, contracts, loans from financial institution, credit card payments, Lending Club, etc.).  Initiate and follow through on patients’ applications for commercial payment plans.  Maintain contact with patients throughout treatment to assist with payment problems, verify that payments are timely made, and to intervene on the patient’s behalf with third-party payers.  Process and follow through on any third party or agency claims.  File forms, monitor payments, maintain records, and produce reports. Work with members of the COD Business Office to collect balances, process claims, and troubleshoot all reimbursement problems for Faculty Practice(FP) and follow up on insurance claims monthly.  Maintain current knowledge of third-party payer contracts; agency rules and regulations; Current Dental Terminology.  Responsible for all doctor provider schedules and meeting production goals.  Provide doctors with planned appointment list every two weeks.  Follow-up with unscheduled patients. Review and work each doctor’s accounts receivable report. Report the doctor’s spreadsheet of findings to individual doctor, department director and practice manager monthly. Review schedule daily and inform front desk of balances to collect or any other financial responsibilities for patients. Meet with new patients and existing patients to discuss treatment plans, approximate insurance coverage and financial responsibility and ensure we have an electronically signed treatment plan on file.

Serve as Restorative Dental Sciences, FP point-of-contact (POC) for all reimbursement, insurance, and coding issues: Receive all telephone calls and walk-in inquiries concerning billing, reimbursement, dental insurance or other dental payment questions.  Maintain up-to-date knowledge in these areas and provide clear and appropriate information to questioners.  Maintain updated patient information and documentation in Axium.  Actively maintain communication with faculty members to provide current information regarding their patients’ financial status, especially as it affects treatment-planning choices.  Respond to requests from dental faculty members to resolve payment issues as they arise.  Provide timely feedback to faculty members regarding efforts towards resolution of financial concerns. Monitor upcoming patient schedules to determine any balances due prior to appointment and arrange to meet patients when necessary.  Routinely alert doctors of balances due and discuss collection options.

Using accounts receivable reports for all practitioners in the RDS FP Patient Care Center; follow collection procedures, which include telephone contact of patients and/or guarantors to request payment of balances due; generating collection letters; documenting collection action; and reporting collections outcomes to practice administrator, doctors, practice director and RDS chair monthly.  Determine which accounts should be sent to an outside collection agency and present cases to doctors for approval monthly.  Submit accounts to Billing Office for write-off or provide instructions for further follow-up monthly.  Print, review, and analyze FP aging report monthly, adding comments to patient accounts relative to the same monthly. Follow up on any dental preauthorization’s sent on behalf of patients monthly.

As member of front office team, routinely answer main telephone lines and provide information to callers on dental treatment choices available in the college as a whole. Responsible for obtaining or confirming required credentialing of dentists with third-party payers.  Assist doctors with submitting required forms and documentation.

In absence of Office Manager, ensure the front desk is adequately covered, filling-in when necessary.  Perform other duties as assigned.