Financial Counselor

Location: Central Georgia Cancer Care

Pay Range: $17.93 - $29.89

About the role

A Financial Counselor serves as the liaison between the patient and the practice by coordinating payments, assistance, monitoring patient balances, and streamlining communication of the financial responsibilities of our patients. Performs the quality control function for pre-certification and prior authorization. The Financial Counselor ensures the patients’ insurance benefits are kept up to date in the electronic medical records (EMR) and billing software while also verifying the patient’s services meet insurance coverage appropriateness.

Responsibilities

• Monitors and coordinates internally and externally with the insurance company on the pre-certification and prior authorization processes, including peer-2-peer and appeals, seeking support from provider or pharmacy team when applicable.
• Reviews assigned patient(s) and/or Physician schedules for upcoming visits and/or treatment to establish patient financial responsibility.
• Reviews patients’ treatment plan(s) and identifies if insurance benefit coverage is active and patient fiscal responsibility; all unplanned exceptions are to be communicated to provider immediately.
• Reviews and identifies new treatment orders, generates an estimate of service, and reviews with patient explaining insurance benefits and fiscal responsibility.
• If applicable, obtains necessary information from patient for assistance income guidelines.
• Identifies and reviews patient ageing balances and establishes proper arrangements with the patient to address outstanding balance(s).
• Discusses and explains forms and paperwork needed such as waivers, treatment estimates, payment plans, assistance applications, etc.
• Communicates openly and routinely throughout the course of the workday with providers, nursing staff, PSS staff, UM team, and coworkers through Teams, phone calls, emails, and in person to discuss fiscal responsibility and other items as needed.
• Works closely with outside entities to ensure full collaboration and completion of forms and items needed in a timely and sometimes urgent manner.
• Assists patient(s) with completing necessary paperwork for assistance and other grant-funded programs in order to secure financial aid for treatment and services.
• Has an understanding of patient assistance programs and grant services processes to ensure adequate application, placement, and coordination with financial aid counseling team.
• Understands and complies with all Federal and State laws and regulations pertaining to patient care, rights, safety, billing, and collections.
• Works overtime when given sufficient notice of required overtime.
• Keeps work area and records in a neat and orderly manner.
• Maintains all company equipment in a safe and working order.
• Adheres to all AON and departmental policies and procedures, including Revenue cycle policies and procedures.
• Performs other duties and projects as assigned.

Requirements

• High school Diploma or GED required. Further education or degree a plus.
• Minimum of two years prior experience in the healthcare field, preferably in a clinical or business office setting.
• Prior experience in healthcare customer service, medical terminology, medical insurance verification, and verifying pre-certification and/or prior authorization with medical insurance.
• Excellent verbal and communication skills.
• Insurance knowledge requirements including an understanding of medical terminology, ICD-9, ICD-10, and CPT codes.
• Prior cash handling and monetary collection experience.
• Ability to calculate and collect patients’ responsibility and insurance co-pay/coinsurance.

Skills

• Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management, and organizational skills. Must be detail-oriented with the ability to exercise independent judgment.
• Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.
• Communication Skills: Good command of the English language. Second language is an asset but not required. Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.
• Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness, and operational excellence through best practices, strong business and political acumen, collaboration, and partnerships, as well as positive employee, physician, and community relations.
• Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability to work independently with limited supervision. Ability to work remotely effectively as required. Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.
• Computer Skills: Proficiency in MS Office Word, Excel, Power Point, and Outlook required. Ability to use multiple screens to perform required job functions. Ability to navigate multiple applications and tab in and out of workflow to complete tasks.

Schedule

Monday to Friday, 8:00 AM – 5:00 PM. Occasional overtime may be required, and weekend shifts based on location hours and operational needs.