Financial Care Counselor

Role Overview

• Accurately complete patient accounts per departmental protocols, policies, procedures, and regulatory compliance.
• Perform pre-admission, admission, pre-registration, and registration functions.
• Ensure insurance requirements are met before patient arrival.
• Inform patients of financial liability prior to service.
• Arrange payment options with patients and screen for government funding eligibility.
• Analyze insurance coverage and benefits to ensure timely reimbursement.
• Obtain prior authorizations and certifications as needed.
• Facilitate payment options for uninsured patients.
• Investigate accidents to determine liability and appropriate payer sources.
• Accurately admit, register, and pre-register patients with demographic and financial data.
• Resolve insurance claim rejections and denials promptly.
• Calculate and collect patient payments; reconcile daily cash deposits.
• Evaluate diagnoses for Medicare policy compliance.
• Ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgets and reporting.
• Explain bills per PRMO credit and collection policies.
• Initiate and manage appropriate collection efforts and assist with payment plans.
• Refer patients for financial counseling as needed.
• Assess need for and process third-party sponsorships.
• Review insurance policies and funding materials to determine payment sources.
• Notify physicians of patients experiencing financial hardship.
• Complete managed care waiver forms for out-of-network patients.
• Update billing systems with accurate insurance status.
• Refer patients to Manufacturer Drug Programs as needed.
• Greet and assist patients and visitors; explain policies and resolve issues.
• Gather documentation to support inquiries and complaints.
• Provide departmental coverage upon request.
• Obtain authorizations based on insurance guidelines and contracts.
• Accurately document in billing systems per policy and procedure.
• Enter and update referrals as needed.
• Communicate with insurance carriers to resolve clinical and coverage issues.

Requirements

• High school diploma required; some post-secondary education preferred.
• Two years of experience in hospital or clinical service access, physician office, or billing/collections, OR
• Associate’s degree in a healthcare-related field and one year of public-facing experience, OR
• Bachelor’s degree and one year of public-facing experience
• Working knowledge of related business functions is desirable.
• Must possess excellent oral and written communication skills.
• Strong interpersonal skills; able to build service-oriented relationships.
• Understanding of and adherence to institutional policies and procedures.

Benefits

• Excellent communication
• Exceptional customer service skills
• Support your personal well-being
• Excellent work environment