Financial Counselor

American Oncology Network•Columbus, OH

7d•$20 - $30

About The Position

The Financial Counselor serves as the primary patient advocate for financial navigation and counseling within an oncology practice. The role reviews insurance coverage, estimates patient financial responsibility, and coordinates prior authorizations and benefit verification to support access to cancer treatment. The counselor explains insurance benefits, out-of-pocket costs, and available financial assistance programs, and works with clinical teams, insurers, and external assistance organizations to reduce financial barriers while supporting patient collections compassionately. The position coordinates pre-certification and prior authorization activities, including peer-to-peer reviews and appeals; reviews upcoming visits and treatment plans; maintains accurate insurance information in EMR systems; and prepares and explains service estimates. It also supports patients with forms, payment plans, assistance applications, grants, and outstanding balances. The Financial Counselor must follow applicable laws, regulations, HIPAA requirements, and organizational policies, while communicating professionally and compassionately with patients and families.

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 copayments, and coinsurance.
Insurance knowledge, including understanding of medical terminology and ICD-9, ICD-10, and CPT codes.
Strong verbal and communication skills to support diverse patient populations with empathy and cultural sensitivity.
Proficiency in 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 with insurance companies on pre-certification and prior authorization processes, including peer-to-peer reviews and appeals, seeking provider or pharmacy support when applicable.
Review patient and physician schedules for upcoming visits or treatment and establish patient financial responsibility.
Review treatment plans to confirm active insurance coverage and patient responsibility, and immediately communicate unplanned exceptions to providers.
Identify new treatment orders, generate service estimates, and explain insurance benefits and financial responsibility to patients.
Keep patient insurance benefits current 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 required forms and paperwork, including waivers, treatment estimates, payment plans, and assistance applications.
Help patients complete paperwork for financial assistance and grant-funded programs.
Understand patient assistance programs and grant processes to support appropriate applications, placement, and coordination with the financial aid counseling team.
Obtain patient information needed to assess assistance income guidelines, when applicable.
Review patient aging balances and establish arrangements to address outstanding balances.
Work with external entities to complete required forms and items promptly, including when urgent.
Monitor and collect patient financial responsibilities compassionately and professionally.
Comply with federal and state laws and regulations concerning patient care, rights, safety, billing, and collections.
Protect the confidentiality of patient and employee information in accordance with HIPAA.
Follow company and departmental policies and procedures.
Advocate for patients navigating financial complexities and communicate compassionately with patients and families about financially sensitive matters.