Financial Counselor

Job Description Summary

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 policies.

Primary Job Duties & Responsibilities

• Maintains coordination with insurance companies on pre-certification and prior authorization processes, including peer-to-peer interactions and appeals.
• Reviews patient schedules and treatment plans to establish financial responsibility and communicate with patients about their insurance benefits and responsibilities.
• Verifies patient services against insurance coverage and updates EMR and billing software accordingly.
• Communicates with providers, nursing staff, PSS staff, and coworkers to discuss financial responsibilities and other items as needed.
• Collaborates with external entities to ensure timely completion of forms and items needed.
• Aids patients in completing necessary paperwork for assistance and grant-funded programs.
• Understands and complies with relevant federal and state laws and regulations regarding patient care, rights, safety, billing, and collections.
• Ensures work area and records are maintained in a neat and orderly manner.
• Adheres to company policies and procedures, including revenue cycle policies and procedures.
• Performs other duties and projects as assigned.

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, and prior verifications of pre-certification and/or prior authorization with medical insurance are preferred.
• Experience: Excellent verbal and communication skills, proven insurance knowledge including understanding of medical terminology, ICD9, ICD10, and CPT codes, prior cash handling and monetary collection experience, and ability to calculate and collect patients' responsibility and insurance co-pay/coinsurance.
• Core Capabilities: Analysis & Critical Thinking, Interpersonal Effectiveness, Communication Skills, Customer Service & Organizational Awareness, Self-Management, Computer Skills, Travel, Standard Core Workdays/Hours.