Financial Counselor

Job Description

A Financial counselor serves as the liaison between the patient and the practice by coordinating payments, assisting with financial responsibilities, and ensuring compliance with insurance coverage.

Primary Job Duties & Responsibilities

• Maintains coordination with insurance companies on pre-certification and prior authorization processes, including peer-to-peer and appeals.
• Reviews patient schedules and treatment plans to establish financial responsibility and identifies any unplanned exceptions.
• Verifies patient insurance benefits and updates EMR and billing software.
• Communicates with patients about insurance benefits and financial responsibilities, including discussing forms and payment plans.
• Works with external entities to ensure timely completion of forms and items needed.
• Affords assistance to patients with financial aid applications and grant-funded programs.
• Ensures compliance with federal and state laws and regulations related to patient care, rights, safety, billing, and collections.
• Manages work area and records in a neat and orderly manner.
• Adheres to company policies and procedures, including revenue cycle policies and procedures.

Job Qualifications And Requirements

• Education: High school diploma or GED required. Further education or degree a plus.
• Certifications/Licenses: Two years prior experience in healthcare field, preferably in a clinical or business office setting required. Prior healthcare customer service, medical terminology, medical insurance verification, pre-certification and prior authorization with medical insurance, excellent verbal and communication skills, prior cash handling and monetary collection experience, and ability to calculate and collect patients' responsibility and insurance co-pay/coinsurance.
• Core Capabilities: Critical thinking skills, interpersonal effectiveness, communication skills, customer service & organizational awareness, self-management, computer skills, travel, standard core workdays/hours.