Financial Counseling Representative

R1 RCM•Evansville, IN

4d•$15 - $21•Remote

About The Position

This US-based position involves providing financial counseling to patients, acting as an advocate for them with insurance carriers, and explaining financial responsibilities. The role requires counseling patients on their insurance benefits, recommending alternative payment sources, and assisting uninsured patients with applications for Medicaid or other assistance programs. It also involves inter-departmental collaboration with Case Management, Clinical Staff, Medicaid Vendor, and the Family Independence Agency to ensure patients receive necessary support and approvals for services. The position emphasizes metric-driven performance, strong customer service, and contributing to a team environment focused on continuous learning and making a difference in the community.

Requirements

Exceptional subject matter expertise of all funding source options.
Proven ability to consistently meet productivity goals and drive high-quality work output.
High School - Equivalent experience will be considered
Minimum of 4 years of experience

Responsibilities

Contact/check insurance carriers and websites for non-automated eligibility and act as an advocate for the patient.
When limited benefit plans are identified, counsel patients on their insurance benefits and recommend alternative sources of payment and financial assistance when appropriate.
Explain financial responsibilities for services received, payment options, and point of service collections on procedures to patients or parties responsible for payment.
Provide assistance to uninsured patients and families in completing and filing Medicaid or assistance program applications with the appropriate agency.
Provide patients and their families support with gathering necessary documents for Medicaid or assistance programs.
Serve as liaison between Case Management, Clinical Staff, Medicaid Vendor, and Family Independence Agency to assist patients and families in completing assistance program applications and determine eligibility and coverage.
Notify manager, physician and servicing department of possible delay of service for any elective, non-urgent admissions, procedures and scheduled diagnostic testing which have not been approved prior to the date of service.
Assists leadership with analysis of screening & solution defect reviews and denials analysis.
Takes strong accountability for team’s screening, solution, and conversion metric performance.
Provides hands-on training, mentoring, and aiding to other team members as needed.
Provide excellent customer service by going above and beyond to create a great experience for patients.
When complex enrollment issues occur, associate drives resolution and supports other team members with resolution.
Leverage excellent customer service to assist with resolving patient escalations related to billing or other concerns, leveraging CSU or other appropriate channels of resolution as needed.
Perform all other duties and projects as assigned.