Financial Counselor

American Oncology Network•Hot Springs, AR

7d•Onsite

About The Position

The Financial Counselor serves as the primary patient advocate for financial navigation and counseling within an oncology practice. The role reviews patient insurance coverage, estimates financial responsibility, and coordinates prior authorizations and benefit verification to support access to cancer treatment. It helps patients understand insurance benefits, out-of-pocket costs, and available financial assistance, and works with clinical teams, insurers, and external assistance organizations to address financial barriers and patient collections while providing compassionate support.

Requirements

High school diploma or equivalent.
At least two years of experience in the healthcare field.
Demonstrated knowledge verifying medical insurance pre-certification and/or prior authorization.
Prior cash-handling and monetary collection experience.
Ability to calculate and collect patient responsibility, insurance copays, and coinsurance.
Insurance knowledge, including understanding medical terminology and ICD-9, ICD-10, and CPT codes.
Strong verbal and written communication skills to support diverse patient populations with empathy and cultural sensitivity.
Proficiency with EMR systems, practice management software, and insurance verification tools.
Advanced proficiency in Microsoft Office Suite, including Word, Excel, and Outlook.
Strong interpersonal and communication skills, including the ability to explain financial information in understandable terms.
Ability to collaborate with clinical teams, insurance companies, and external organizations.

Nice To Haves

Associate's degree or higher in Healthcare Administration, Business, or a related field.
Experience in healthcare financial counseling, patient access, or medical billing.
Experience with patient assistance programs and financial aid resources.
Familiarity with patient assistance programs, grant-funded resources, and pharmaceutical assistance programs.

Responsibilities

Coordinate insurance pre-certification and prior authorization processes, including peer-to-peer reviews and appeals, and seek support from providers or the pharmacy team when applicable.
Review patient and physician schedules for upcoming visits or treatment and establish patient financial responsibility.
Review treatment plans and verify active insurance coverage and patient responsibility; promptly communicate unplanned exceptions to the provider.
Review new treatment orders, prepare service estimates, and explain insurance benefits and financial responsibility to patients.
Maintain up-to-date patient insurance benefits in EMR systems and review services for diagnosis and insurance coverage appropriateness.
Communicate routinely with providers, nursing staff, PSS staff, the UM team, and coworkers about financial responsibility and related matters.
Explain forms and paperwork, including waivers, treatment estimates, payment plans, and assistance applications.
Help patients complete applications for financial assistance and grant-funded programs; coordinate with the financial aid counseling team and obtain income information when applicable.
Review aging patient balances and establish arrangements to address outstanding balances.
Collaborate with external organizations to complete required forms and other items in a timely manner.
Monitor and collect patient financial responsibilities compassionately and professionally.
Comply with federal and state requirements relating to patient care, rights, safety, billing, and collections, as well as HIPAA and company policies.
Advocate for patients navigating financial complexities and communicate compassionately with patients and families about sensitive financial matters.