The Financial Counselor is a highly specialized revenue cycle advocate who serves as the critical liaison between patients, clinical operations, third-party payers, and Covenant HealthCare. This role is directly responsible for mitigating institutional financial risk while ensuring patient access to care through the navigation of complex, highly regulated financial frameworks.
The scope of this position requires advanced technical expertise in multi-specialty insurance verification, state and federal eligibility programs, complex legal/regulatory compliance, and specialized corporate treasury and banking support. Financial Counselors must exercise independent judgment, advanced problem-solving, and meticulous attention to detail to drive front-end revenue integrity, optimize first-touch claim resolution, and uphold Covenant HealthCare’s commitment to delivering Extraordinary Care for Every Generation.
Responsibilities:Advanced Insurance Verification & Revenue Integrity
Multi-Payer Coverage Analytics
Validate, interpret, and configure complex commercial, state, and federal insurance benefits within the Electronic Health Record (EHR) to prevent downstream denials and ensure optimal facility and professional reimbursement.
Front-End Authorization & Denial Prevention
Analyze inpatient and outpatient accounts for real-time insurance modifications, driving immediate updates to Utilization Management to secure timely authorizations and eliminate preventable clearinghouse or claim-edit rejections.
Specialized Payer Navigation
Investigate, secure, and manage high-complexity accounts, including Michigan Auto No-Fault (MACP), Workers' Compensation statutory rules, and Veteran’s Administration (VA) Care Acts, ensuring precise regulatory compliance and accurate primary/secondary payer formatting.
Regulatory Pricing Compliance: Regulatory Pricing Disclosure & Communication
Conduct patient financial interviews to review, explain, and legally disclose complex hospital pricing structures and Good Faith Estimates (GFE) to patients in compliance with state and federal No Surprises Act mandates, while securing necessary pre-service payment arrangements
Concurrent Window & Workflow Management
Efficiently staff the public-facing cashier’s window to process payments, inquiries, and applications while concurrently managing digital system work queues, insurance verifications, and desk workflows during intervals between face-to-face patient interactions.
Account Eligibility & State/Federal Casework
State & Federal Program Navigation
Serve as a certified MDHHS MI Bridges Navigator and Certified Application Counselor (CAC) for the Federal Funded Market Place (FFM), acting as an authorized institutional representative to execute Medicaid, Spend-down, and Federal Marketplace applications
Clinical Outreach & Case Resolution
Conduct targeted clinical unit/bedside interventions to interview patients, capture critical financial data, resolve complex Coordination of Benefits (COB) conflicts, and process retroactive state medical assistance applications with strict supporting documentation.
Payer Advocacy & Dispute Resolution
Collaborate directly with MDHHS caseworkers, Federal Exchange supervisors, and insurance adjusters to expedite complex eligibility determinations and resolve enrollment barriers on behalf of the health system and the patient.
Financial Counseling & Navigation
Educate patients and families on complex healthcare financial structures (e.g., deductibles, coinsurance, self-pay liabilities, and institutional financial assistance programs) both via telephone and in person at the cashier's window to mitigate financial toxicity and resolve billing friction.
Account History Review & Analysis
Analyze complex account histories within Epic to interpret charges, payments, and insurance adjustments, translating intricate financial data into clear, understandable language for patients and families.
Discrepancy Identification
Investigate patient billing inquiries and coordination disputes to identify underlying system registration errors, eligibility mismatches, or inaccurate charge captures.
Strategic Revenue Cycle Escalation
Act as a front-line quality check by promptly escalating identified account discrepancies, system errors, or required adjustments to the appropriate Hospital/Professional Billers or Revenue Cycle leadership for formal correction.
Cross-Departmental Financial Management
Provide comprehensive institutional cashiering and banking support services, executing secure payment processing, balancing high-volume transactions, and logging deposits across multiple hospital departments into the corporate finance system
Patient & Departmental Deposit Processing
Securely accept and process patient payments and departmental funds, ensuring all cash, checks, and credit transactions are meticulously documented and prepared for secure transport.
Chain-of-Custody & Armored Transport Coordination
Manage the preparation, documentation, and secure transfer of patient payments and departmental deposits to the Loomis armored truck company, strictly adhering to institutional security and verification protocols.
Cash Management & Cash Operations
Manage, dispense, and reconcile corporate Petty Cash reserves, execute formal banking change orders, and balance daily institutional deposits to ensure absolute financial accountability and internal control compliance.
Manage specialized system work queues, correct demographic/guarantor mismatches, and maintain clean data integrity between patient access and central billing offices.Continuous Lean Optimization
Actively drive departmental Process Improvement, utilize Lean methodologies and Managing Daily Improvement (MDI) tools to perform root-cause analysis on front-end workflow errors and registration-driven denials.
Legal & Corporate Support
Provide official Notary Public services for hospital business, execute required document imaging/scanning, and maintain complete alignment with HIPAA and patient confidentiality mandates
Qualifications:Education & Experience
Knowledge, Skills, and Abilities
Working Conditions & Physical Requirements