Job ID 3200-Financial Counselor

Job Summary

The Financial Counselor is responsible for performing financial clearance functions including insurance verification, prior authorization review, referral validation, and patient financial counseling to ensure patients are financially cleared prior to services. This role works collaboratively with clinic staff, providers, revenue cycle teams, and payers to promote accurate financial clearance, minimize financial risk to the organization, and ensure a positive patient financial experience.

Essential Job Functions

• Perform benefits verification for scheduled services.
• Validate prior authorization requirements and ensure approvals are obtained timely when required.
• Review referrals for accuracy and completeness based on payer requirements.
• Calculate and communicate patient financial responsibility (copays, deductibles, coinsurance, non-covered services).
• Conduct financial counseling conversations with patients in a professional, empathetic, and compliant manner.
• Collect pre-service payments in accordance with organizational policies.
• Review accounts for potential financial assistance eligibility and guide patients through available programs when applicable.
• Document all verification, authorization, and counseling activity accurately within the practice management system.
• Maintain knowledge of payer-specific requirements, fee schedules, and coverage guidelines.
• Identify and escalate payer discrepancies, workflow issues, or system errors impacting financial clearance.
• Collaborate with Scheduling, Authorization, Charge Capture, and AR teams to ensure seamless revenue cycle workflow.
• Support denial prevention by ensuring accuracy of insurance selection, coverage validation, and authorization documentation.
• Follow established workflows to prevent under- or over-collection.
• Adhere to compliance standards, HIPAA regulations, contractual obligations, and the organization’s Code of Conduct.
• Participate in departmental meetings, training sessions, and process improvement initiatives as assigned.

Work Environment

Fast-paced, deadline-oriented, onsite. This is a full-time position with standard business hours and occasional travel may be required.

Physical Demands

• Prolonged sitting and computer use.
• Frequent use of hands for typing and data entry.
• Occasional standing, walking, bending, or reaching.
• Visual acuity required for detailed computer work.

Position Type and Expected Hours of Work

Full-time position. Standard business hours with flexibility based on operational needs.

Travel

Occasional travel may be required.