Financial Counselor

US Eye•Sarasota, FL

1d•Onsite

About The Position

The Financial Counselor is responsible for performing financial clearance functions including insurance verification, prior authorization review, referral validation, and patient financial counseling to ensure patients are financially cleared prior to services. This role works collaboratively with clinic staff, providers, revenue cycle teams, and payers to promote accurate financial clearance, minimize financial risk to the organization, and ensure a positive patient financial experience. The Financial Counselor must understand Revenue Cycle workflows, payer practices, utilization management, and basic coding principles to ensure accurate and timely financial clearance.

Requirements

Minimum of 2–3 years of experience in healthcare revenue cycle, financial counseling, insurance verification, or related field
Experience supporting physician group practices preferred
Knowledge of insurance verification, prior authorization, referrals, and patient responsibility calculations
Understanding of payer guidelines and basic coding principles
Proficient in Microsoft Office (Word, Excel, Outlook)
Strong data entry accuracy and attention to detail
Excellent verbal and written communication skills
Strong interpersonal skills with the ability to handle sensitive financial discussions professionally
Ability to multitask and prioritize in a deadline-driven environment
Ability to work independently in a remote or hybrid environment
Strong organizational skills and time management

Nice To Haves

Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred
Experience with NextGen and eligibility platforms
Experience with financial assistance programs

Responsibilities

Perform benefits verification for scheduled services.
Validate prior authorization requirements and ensure approvals are obtained timely when required.
Review referrals for accuracy and completeness based on payer requirements.
Calculate and communicate patient financial responsibility (copays, deductibles, coinsurance, non-covered services).
Conduct financial counseling conversations with patients in a professional, empathetic, and compliant manner.
Collect pre-service payments in accordance with organizational policies.
Review accounts for potential financial assistance eligibility and guide patients through available programs when applicable.
Document all verification, authorization, and counseling activity accurately within the practice management system.
Maintain knowledge of payer-specific requirements, fee schedules, and coverage guidelines.
Identify and escalate payer discrepancies, workflow issues, or system errors impacting financial clearance.
Collaborate with Scheduling, Authorization, Charge Capture, and AR teams to ensure seamless revenue cycle workflow.
Support denial prevention by ensuring accuracy of insurance selection, coverage validation, and authorization documentation.
Follow established workflows to prevent under- or over-collection.
Adhere to compliance standards, HIPAA regulations, contractual obligations, and the organization’s Code of Conduct.
Participate in departmental meetings, training sessions, and process improvement initiatives as assigned.