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

• Maintain open communication with insurance companies regarding pre-certification and prior authorization processes.
• Review patient schedules and treatment plans to establish financial responsibility.
• Monitor and update patient insurance benefits in EMR and billing software.
• Communicate with patients about their insurance coverage and financial obligations.
• Work with external entities to complete necessary paperwork for financial aid programs.
• Handle patient paperwork for assistance and grant-funded programs.
• Ensure compliance with federal and state laws related to patient care, rights, safety, billing, and collections.
• Perform quality control for pre-certification and prior authorization processes.
• Manage patient balances and establish payment arrangements.
• Provide ongoing communication with providers, nursing staff, and other relevant parties.
• Collaborate with outside entities to ensure timely completion of forms and items.

Job Qualifications And Requirements

• Education: High school diploma or GED required. Further education or degree preferred.
• Certifications/Licenses: Two years of prior experience in healthcare field, preferably in a clinical or business office setting required. Prior experience in customer service, medical terminology, insurance verification, pre-certification, and prior authorization is beneficial.
• Skills: Excellent verbal and communication skills, proven insurance knowledge including medical terminology, ICD9, ICD10, and CPT codes, cash handling and monetary collection experience, ability to calculate and collect patients' responsibility, critical thinking, problem-solving, analysis, decision-making, planning, time management, and organizational skills.
• Core Capabilities: Analytical, interpersonal, communication, customer service, organizational awareness, self-management, computer proficiency, and travel.