Surgical Financial Counselor

Peachtree Orthopaedic Clinic•Atlanta, GA

7d•Onsite

About The Position

The Surgery Financial Counselor supports the financial clearance and patient financial services functions of the Revenue Cycle department. This role is responsible for insurance verification, benefit analysis, cost estimation, financial counseling, deposit collection, and patient payment coordination for surgical procedures performed in ambulatory surgery centers and hospital settings. The Counselor partners with patients, providers, payers, and internal departments to ensure accurate financial information, regulatory compliance, and an exceptional patient experience.

Requirements

Minimum 2 years of healthcare financial counseling, patient account management, insurance verification, or revenue cycle experience required.
Strong understanding of insurance benefits, patient financial responsibility calculations, reimbursement methodologies, and revenue cycle operations.
Demonstrated analytical, communication, customer service, organizational, and problem-solving skills.
Ability to manage multiple priorities in a fast-paced environment while maintaining attention to detail and operational accuracy.

Nice To Haves

Associate degree in Finance, Accounting, Healthcare Administration, Business, or related field preferred; equivalent healthcare revenue cycle experience required.
Knowledge of ICD-10, CPT, HCPCS coding, CMS 1500/UB04 claim forms, Medicare, managed care, and commercial insurance plans preferred.
Experience with Athena, Microsoft Excel, Word, PowerPoint, and healthcare billing systems preferred.
Certified Patient Account Representative (CPAR) preferred.

Responsibilities

Review scheduled surgical cases and generate financial clearance reports to identify patients requiring benefit verification, cost estimation, and financial counseling.
Verify insurance eligibility, benefits, deductibles, co-payments, co-insurance amounts, out-of-pocket obligations, and authorization requirements for surgical procedures.
Analyze payer benefits and coverage details to determine patient financial responsibility for professional and facility services.
Prepare and communicate detailed cost estimates to patients and guarantors prior to scheduled surgical procedures.
Educate patients regarding insurance benefits, financial obligations, payment options, and available financial assistance programs.
Establish deposit requirements, collect pre-service payments, and coordinate payment arrangements in accordance with organizational policies.
Review and process financial assistance applications while maintaining accurate documentation and reporting of eligibility determinations.
Maintain accurate account documentation, financial calculations, benefit verification details, and patient communications within Athena and related systems.
Prepare daily, weekly, and monthly operational reports related to surgical financial clearance activities, collections, and reimbursement support.
Serve as a subject matter expert for patient financial counseling processes, insurance benefits, and revenue cycle workflows related to surgical services.
Collaborate with Scheduling, Clinical, ASC Operations, Billing, Front Desk, and Revenue Cycle teams to resolve financial concerns and improve workflow efficiency.
Support onboarding and training activities for new team members as assigned.
Ensure compliance with HIPAA, CMS guidelines, payer regulations, and organizational financial policies and procedures.
Participate in departmental meetings, audits, compliance activities, and process improvement initiatives as assigned.
Other duties as assigned.