Financial Counselor

Overview:

PURPOSE STATEMENT: 

The Financial Counselor is responsible for helping patients and their families understand insurance benefits, financial obligations, and available payment options while ensuring accurate financial clearance processes. This position performs insurance verification, financial counseling, upfront collections, payment arrangement administration, financial assistance screening, and account maintenance. The Financial Counselor serves as a key patient advocate, demonstrating compassion, empathy, patience, and emotional intelligence while supporting individuals through potentially challenging financial and healthcare situations.  

Responsibilities:

ESSENTIAL FUNCTIONS: 

• Verify insurance eligibility, benefits, authorizations, and coverage information to support accurate patient financial responsibility estimates. 

• Audit admission and registration documentation for accuracy, completeness, and compliance with organizational requirements. 

• Review, update, and maintain patient demographic, insurance, and guarantor information within designated patient accounting systems. 

• Educate and counsel patients and guarantors regarding insurance benefits, coverage limitations, deductibles, copayments, coinsurance, out-of-pocket expenses, and available payment options. 

• Collect patient financial responsibility amounts, including deductibles, copayments, coinsurance, and outstanding balances, in accordance with organizational policies. 

• Facilitate payment arrangements and educate patients on available financial assistance programs. 

• Complete financial assistance applications and obtain, review, and validate required income and expense documentation. 

• Prepare and process charity care requests, administrative adjustment requests, and payment plan documentation as appropriate. 

• Maintain collection, charity care, financial assistance, and adjustment logs, ensuring accuracy and timely reporting. 

• Analyze patient account information and take appropriate actions to support timely reimbursement and account resolution. 

• Collaborate with admissions, revenue cycle, business office, and clinical teams to resolve insurance and financial issues impacting patient accounts. 

• Ensure compliance with all applicable federal, state, payer, and organizational policies related to patient financial services. 

 

OTHER FUNCTIONS:  

• ​Assist with special projects, audits, reporting requests, and process improvement initiatives as assigned. Support departmental goals related to revenue cycle performance, collections, and patient satisfaction. Participate in training and educational activities to maintain knowledge of insurance regulations, reimbursement practices, and organizational procedures. Provide backup support for other business office functions as needed. Perform other duties as assigned.

Qualifications:

STANDARD EXPECTATIONS: 

• Complies with all organizational policies, procedures, regulatory requirements, and performance improvement initiatives. 

• Maintains confidentiality of patient, employee, and organizational information in accordance with applicable privacy regulations and organizational standards. 

• Communicates clearly, professionally, and effectively with patients, families, visitors, physicians, coworkers, and other members of the healthcare team. 

• Demonstrates compassion, empathy, patience, professionalism, and emotional intelligence in all patient interactions. 

• Develops and maintains constructive, cooperative working relationships with internal and external stakeholders. 

• Promotes teamwork by fostering mutual trust, respect, collaboration, and cooperation among team members. 

• Maintains regular, reliable, and predictable attendance. 

• Consistently demonstrates excellent customer service and patient-focused behaviors. 

• Adheres to all safety, compliance, and ethical standards of the organization. 

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

• High School Diploma or equivalent required 

• Associate's degree in Business Administration, Healthcare Administration, Accounting, Finance, or a related field preferred. 

• Minimum of three (3) years of experience in healthcare financial counseling, patient access, patient accounting, medical billing, collections, or a related healthcare revenue cycle function. 

• Experience working with Commercial, Medicare, and Medicaid insurance programs required. 

• Five (5) or more years of healthcare financial counseling, collections, or revenue cycle experience. 

• Experience within a hospital, behavioral health, or acute care environment preferred. 

• Thorough knowledge of Commercial Insurance, Medicare, Medicaid, and patient financial responsibility requirements. 

• Knowledge of healthcare billing, reimbursement, revenue cycle, and collection practices. 

• Strong customer service and interpersonal skills. 

• Ability to communicate complex insurance and financial information in a clear, compassionate, and understandable manner. 

• Strong problem-solving, analytical, and critical-thinking skills. 

• Excellent verbal and written communication skills. 

• Ability to manage sensitive conversations with professionalism, empathy, and discretion. 

• Proficiency in patient accounting systems, electronic health records, and Microsoft Office applications. 

• Strong organizational skills with attention to detail and accuracy. 

Ability to prioritize multiple tasks and meet deadlines in a fast-paced healthcare environment.