Financial Counseling Representative

R1 RCM•Evansville, IN

6d•$15 - $21•Remote

About The Position

The Financial Counseling Representative will be responsible for contacting insurance carriers to verify eligibility, acting as an advocate for the patient. They will counsel patients on their insurance benefits, recommend alternative payment sources, and explain financial responsibilities for services. This role involves assisting uninsured patients with applications for Medicaid or other assistance programs, and supporting families in gathering necessary documents. The representative will also serve as a liaison between various departments such as Case Management, Clinical Staff, Medicaid Vendor, and the Family Independence Agency to ensure patients receive the necessary assistance. Performance will be measured by productivity goals, quality of work, and contribution to team metrics. The role requires strong customer service skills to create a positive patient experience, resolve complex enrollment issues, and handle patient escalations related to billing or other concerns. The company is committed to equal employment opportunity and providing a workplace free from harassment.

Requirements

High School Diploma or equivalent experience.
Minimum of 4 years of experience.
Extended Computer Usage.

Nice To Haves

Exceptional subject matter expertise of all funding source options.

Responsibilities

Contact/check insurance carriers and websites for non-automated eligibility and act as an advocate for the patient.
Counsel patients on their insurance benefits and recommend alternative sources of payment and financial assistance when limited benefit plans are identified.
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 determining 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.
Consistently meet productivity goals and drive high-quality work output.
Assist leadership with analysis of screening & solution defect reviews and denials analysis.
Take strong accountability for team’s screening, solution, and conversion metric performance.
Provide 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.
Drive resolution for complex enrollment issues and support other team members with resolution.
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.