Patient Financial Counselor - REI/Fertility - Bozeman

Billings Clinic•Bozeman, MT

31d•Onsite

About The Position

The Patient Financial Counselor - REI/Fertility serves as the primary financial contact for patients undergoing fertility evaluation and treatment. This role supports the financial integrity and interests of the REI/IVF department by ensuring patients understand insurance benefits, treatment costs and financial responsibilities prior to initiating care. Coordinate insurance benefit verification, performs financial counseling at the time of pre-registration and pre-certification. This position collaborates closely with clinical staff, revenue cycle teams, and patients to ensure all financial requirements are met prior to treatment start dates.

Requirements

High school graduate or equivalent.
1 year experience in healthcare revenue cycle and patient financial counseling

Nice To Haves

Experience working with insurance verification and prior authorization

Responsibilities

Performs customer service as the primary financial contact for REI/IVF program(s) patients regarding insurance coverage and financial responsibility by providing assistance to patient inquiries including account information, insurance billing issues (including pre-authorization or pre-certification), and quality of care issues as appropriate.
Conducts financial consultations for new and returning patients regarding fertility treatment pricing and plans and associated costs.
Performs financial counseling for self pay, MVA, and commercial insurance patients with deductibles greater than established guidelines.
Provides clear explanation of financial policies, insurance benefits, and payment expectations ensuring the patient's understanding of the processes.
Presents available payment options including self-pay packages, payment plans, and third-party financing programs when appropriate.
Assists patients through financial application and approval processes when utilizing financing programs.
Participates, as needed, and within established guidelines, in negotiation of discounts with customers, including patients, attorney and collection agencies.
Confirms patient insurance eligibility and benefits related to fertility services.
Obtains required prior authorizations and precertification for applicable services prior to treatment initiation.
Coordinates with social workers, care navigators and case managers on an as needed basis regarding pre-certifications/authorizations and other financial aspects on the front end of the revenue cycle in order to impact discharge planning and non-covered services letters.
Coordinates benefit verification and assist benefit verification staff as needed.
Maintains accurate documentation of authorization approvals and payer requirements.
Ensures patients are financially cleared prior to treatment start whenever possible.
Monitors financial readiness for treatment cycles including insurance approval, patient deposits, and payment arrangements.
Communicates changes in treatment plans that may impact patient financial responsibility.
Provides timely responses to patient inquiries related to billing, insurance coverage, financial policies, and treatment costs.
Works collaboratively with Patient Financial Services to support collection of patient balances, manage self-pay account balances for transfer to bad debt and assignment to outside collection agencies.
Collaborates with physicians, nurses, coordinators, and administrative staff to ensure alignment of financial and clinical workflows.
Communicates financial clearance status to clinical teams to support appropriate scheduling of treatment cycles.
Maintains accurate documentation and records related to financial counseling activities.
Support operational workflows for outside monitoring and andrology patients receiving services within the clinic.
Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations.
Meets all mandatory organizational and departmental requirements.
Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
Performs all other duties as assigned or as needed to meet the needs of the department/organization.