Financial Counselor, Transplant, Full Time, First Shift

UC Health•Cincinnati, OH

5d•Onsite

About The Position

The Financial Counselor serves as a patient advocate and financial resource within the Program. The counselor ensures patients understand their insurance coverage, potential out-of-pocket costs, and available financial resources, while working proactively with insurance companies, internal departments, and external partners to secure financial clearance and maximize reimbursement.

Requirements

High School Diploma/GED.

Nice To Haves

Associate’s Degree or Bachelor's Degree.
1 - 2 Years equivalent experience.

Responsibilities

Conduct comprehensive financial assessments for patients.
Explain insurance benefits, coverage limitations, deductibles, co-pays, and potential non-covered services.
Counsel patients and families regarding financial obligations and provide education in planning for long-term related expenses, including immunosuppressant coverage.
Provide information on available financial assistance, charitable programs, and fundraising options.
Serve as a liaison between patients, insurance carriers, and the clinical team to ensure financial readiness prior to listing.
Verify insurance coverage and eligibility for services, testing, and medications.
Obtain prior authorizations for evaluations, procedures, and inpatient admissions as required.
Coordinate with payers, case managers, and third-party administrators to ensure accurate and timely authorization.
Communicate coverage changes, denials, or delays to patients and the department promptly.
Collaborate with financial clearance and billing departments to prevent claim denials and reimbursement delays.
Maintain up-to-date knowledge of Medicare, Medicaid, commercial insurance, and payer requirements.
Assist patients in applying for secondary insurance, Medicaid, or other financial aid when appropriate.
Track and document all financial interactions and decisions in the electronic medical record (e.g., Epic).
Participate in insurance audits and payer updates to ensure compliance and program efficiency.
Identify financial risks that could affect patient eligibility or compliance and communicate concerns to the department.
Participate in multidisciplinary meetings to review financial readiness and patient status.
Partner with department coordinators, social workers, and financial clearance staff to ensure seamless patient support.
Provide ongoing education to team members on payer updates, coverage trends, and financial processes.
Maintain a compassionate and professional demeanor while supporting patients through emotionally and financially stressful situations.
Stay informed of regulatory and policy changes affecting reimbursement and patient financial support.
Contribute to quality improvement initiatives within the financial counseling or program.
Adhere to all UC Health policies, HIPAA regulations, and ethical standards.