Patient Financial Specialist

AleraCare•Sandy, UT

About The Position

The Financial Counselor is responsible for securing and managing all aspects of patient financial assistance for high-cost infusion therapies. This includes program screening, application submission, reimbursement tracking, and coordination with billing teams to ensure assistance funds are applied appropriately. The role directly supports reduced patient balances and improved claim collectability by maintaining accurate, real-time documentation across Salesforce and AdvancedMD. Success is measured by timely enrollments, assistance utilization rates, and effective communication with patients and payer vendors.

Requirements

Minimum 2–3 years of experience in a healthcare financial counseling, copay assistance, or revenue cycle role, preferably in the infusion or specialty pharmacy setting.
Strong working knowledge of commercial copay assistance programs, foundations, and eligibility requirements.
Extensive experience with benefit investigation, coordination of benefits, and reimbursement processes.
Experience using Salesforce and AdvancedMD (or comparable EHR and CRM systems) in a fast-paced RCM environment.
Comfortable working with patients, billing teams, and external vendors.
Excellent attention to detail, ability to meet tight deadlines, and track multiple cases at once with minimal oversight.
Proficiency with Microsoft Excel and document tracking tools.

Responsibilities

Own the full copay assistance pipeline: identify eligible patients, initiate and submit applications, manage renewals, and follow up on payment delivery.
Screen patients within 2 business days of benefit verification and submit applications within 24 hours of patient consent.
Track enrollment status, expiration dates, reimbursement timelines, and unresolved items using Salesforce.
Ensure copay reimbursements are collected and posted accurately in AdvancedMD, targeting a collection rate of ≥ 90% on approved enrollments.
Coordinate with benefit verification, billing, and posting teams to align assistance records with claim activity.
Flag cases with patient balances > $1,000 due to funding delays or payer coordination issues.
Communicate with patients regarding program terms, documentation needed, and any limits to assistance coverage.
Communicate directly with patients regarding program requirements, expected outcomes, and any assistance limits—while maintaining professionalism and accuracy.
Escalate delays or denials to supervisor or RCM leadership and propose alternative funding pathways.
Document all actions and communications in accordance with RCM audit and compliance standards.