Financial Counselor

About the role

Financial Counselors in the Patient Access Department verify patient insurance coverage and obtain required pre-certifications and authorizations from insurance carriers. They coordinate benefits among multiple payors, determine patient responsibility (co-payments, co-insurance, deductibles), and conduct pre-admit telephone interviews to ensure accurate demographic and insurance information is entered into the Hospital Information System. Counselors advise patients of their financial responsibility due at the time of service.

Responsibilities

• Print and review schedules, insurance, and admissions reports from Star and EPIC to secure demographic and financial information for financial investigations.
• Review Emergency Room Visit Payer reports for outpatient financial investigations.
• Verify insurance coverage and benefits via telephone, internet, or fax; document findings in the Star registration notes, including effective date of policy, subscriber, co-pay, and deductible.
• Note CPT codes for specific outpatient insurance verifications and in/out-of-work benefits.
• Conduct pre-admit telephone interviews to gather accurate information for the hospital information system and ensure timely reimbursement.
• Inform patients/guarantors of financial responsibility, including co-payments, co-insurance, and deductibles due at the time of service.
• Refer patients to the Director of Patient Access to secure appropriate self-pay payments when necessary.
• Ensure patients receive appropriate insurance authorizations and referrals per Managed Care guidelines.
• Utilize excellent customer service skills when interacting with patients, doctor’s offices, and insurance companies.
• Advise patients on required documentation (insurance cards, ID, prescriptions) and financial obligations (co-pays, deductibles, authorizations).
• Maintain knowledge of MMC Financial Assistance programs.
• Uphold confidentiality of patients, employees, department, and hospital information, including computer passwords.
• Follow downtime policies and procedures during scheduled and unscheduled downtimes.
• Monitor inpatient/outpatient reports to ensure policies and procedures are followed; make corrections as needed.
• Accept additional related duties with appropriate training.

Requirements

• High School Diploma; some college or equivalent education desirable.
• Previous registration or insurance verification experience desirable.
• Two or more years in a health-related field, preferably in insurance verification.
• Excellence in customer service, interview, and data accumulation skills.
• Keyboard skills at 45 words per minute.
• Medical terminology preferred.

General Requirements

• Commitment to providing the best customer service.
• Reliability in performing assigned tasks.
• Utilization of available resources to make sound decisions.
• Proactive problem-solving and responsibility-taking.
• Collaboration with others toward shared goals, including participation in departmental problem-solving and improvement activities.
• Awareness and respect for cultural diversity among co-workers, patients, and customers.
• Compliance with MMC/CHS policies, Corporate Compliance, HIPAA, Joint Commission, and all regulatory agencies.
• Adherence to attendance and punctuality guidelines.
• Support for change initiatives to ensure continuous performance improvement and service excellence.
• Adherence to a culture of safety, identification of safety/risk issues, and communication to the department director.
• Promotion of teamwork and collaboration.
• Completion of annual mandatory education requirements.
• Completion of hospital-required health screenings.
• Alignment with MMC’s Mission and knowledge of ethical and religious directives.
• Timely completion of goals and assigned projects.

Pay

Salary Range: USD $27.20 per hour. This range is a good faith estimate; actual pay will consider qualifications, skills, competencies, and experience. The salary does not include bonuses, incentives, or the value of benefits.

Benefits

• Generous benefits packages.
• Generous tuition assistance.
• Defined benefit pension plan.
• Culture that supports professional and educational growth.