Financial Counselor

Key Responsibilities

• Respond to a high volume of incoming patient calls related to self-pay statements, billing inquiries, and payment concerns.
• Initiate outbound collection calls to patients on an ongoing basis in a professional and customer-focused manner.
• Review and monitor assigned accounts and collection reports to ensure timely follow-up and resolution.
• Analyze self-pay balances to determine patient financial responsibility, including deductibles, coinsurance, and contractual discounts.
• Establish and monitor payment arrangements and provide timely follow-up on agreed payment plans.
• Process patient payments accurately and in accordance with company procedures.
• Research accounts deemed potentially non-collectible and prepare them for referral to collection agencies as appropriate.
• Ensure all available payment resources have been researched and exhausted prior to escalation.
• Identify billing issues requiring further review (e.g., claim corrections, appeals) and communicate findings to appropriate billing staff through documented patient cases.
• Handle billing loop calls and respond to inquiries from patients, physician offices, and insurance companies.
• Resolve patient billing problems while maintaining excellent customer service and preserving patient relationships.
• Address patient concerns in a calm, courteous, and professional manner, including interactions with dissatisfied patients; escalate concerns to the Quality Department as needed.
• Maintain compliance with HIPAA and all company plans, policies, and procedures set forth by Orthopaedic Solutions Management.

Qualifications

• High School Diploma or GED required.
• Minimum of 5 years of prior medical billing experience or equivalent required.
• Working knowledge of CPT and ICD-10 coding required.
• Demonstrated understanding of Explanation of Benefits (EOBs) and reimbursement practices, including deductibles, coinsurance, and contractual adjustments.