Financial Counselor Jobs

About The Position

Requirements

• High school diploma or equivalent.
• At least two years of experience in the healthcare field.
• Demonstrated knowledge of verifying medical insurance pre-certification and/or prior authorization.
• Prior cash-handling and monetary collection experience.
• Ability to calculate and collect patient responsibility and insurance copayments and coinsurance.
• Knowledge of medical terminology and ICD-9, ICD-10, and CPT codes.
• Excellent verbal and communication skills to support diverse patient populations with empathy and cultural sensitivity.
• Familiarity with patient assistance programs, grant-funded resources, and pharmaceutical assistance programs.
• Proficiency with 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.

Responsibilities

• Coordinate pre-certification and prior authorization processes with insurance companies, including peer-to-peer reviews and appeals, and seek support from providers or pharmacy staff when applicable.
• Review patient and physician schedules for upcoming visits and treatment to establish patient financial responsibility.
• Review treatment plans to confirm active insurance benefit coverage and patient responsibility, and promptly communicate unplanned exceptions to providers.
• Review new treatment orders, generate service estimates, and explain insurance benefits and financial responsibility to patients.
• Maintain current patient insurance benefit information in EMR systems and review services for diagnosis and insurance coverage appropriateness.
• Communicate throughout the workday with providers, nursing staff, PSS staff, the UM team, and coworkers regarding patient financial responsibility and related matters.
• Explain required forms and paperwork, including waivers, treatment estimates, payment plans, and assistance applications.
• Help patients complete paperwork for assistance and grant-funded programs.
• Coordinate patient assistance programs and grant services to support appropriate applications, placement, and financial aid counseling.
• Obtain patient information needed to assess assistance income guidelines, when applicable.
• Review aging patient balances and establish appropriate arrangements to address outstanding balances.
• Collaborate with outside entities to complete required forms and other items in a timely manner, including urgent situations.
• Monitor and collect patient financial responsibilities compassionately and professionally.
• Comply with Federal and State laws and regulations related to patient care, rights, safety, billing, and collections, as well as Company and departmental policies.
• Protect the confidentiality of patient and employee information in accordance with HIPAA.
• Advocate for patients as they navigate financial complexities and communicate sensitively with patients and families.