SUMMARY: The Patient Access Rep - Financial Counselor is responsible for assisting patients and their families in understanding and managing the financial aspects of their healthcare. This includes verifying insurance coverage, estimating out-of-pocket costs, arranging payment plans, and identifying financial assistance programs. The role ensures compliance with hospital policies and regulatory requirements while delivering compassionate and informed support to patients.
ESSENTIAL FUNCTIONS: · Interview patients or their representatives to assess financial status and determine payment options. · Verify insurance eligibility, benefits, and authorization requirements. · Provide cost estimates and explain patient financial responsibility. · Collect deposits, co-pays, and deductibles; establish and monitor payment plans. · Assist patients in applying for financial assistance, charity care, or third-party funding. · Ensure completion of financial documentation in accordance with hospital policies. · Perform medical necessity screening and ensure compliance with system requirements. · Collaborate with clinical departments and physician offices to obtain necessary documentation. · Maintain accurate records and documentation in EHR and financial systems. · Prepare daily deposits and reconcile financial transactions. · Adhere to HIPAA and organizational confidentiality standards. · Performs related duties as assigned.
MINIMUM QUALIFICATIONS
EDUCATION: High school diploma or GED required; associate degree or vocational training in healthcare or finance preferred.
EXPERIENCE: Three (3) years in a healthcare or medical office setting, including experience in insurance verification, financial counseling, or patient access.
LICENSURE OR CERTIFICATION: None required; CHAA or related certification preferred.
KNOWLEDGE, SKILLS, AND ABILITIES: · Knowledge of healthcare billing, insurance plans, and financial assistance programs. · Strong interpersonal and communication skills. · Ability to explain complex financial information in a clear and compassionate manner. · Proficiency in EHR systems, payer portals, and Microsoft Office. · Attention to detail and accuracy in documentation. · Ability to manage multiple tasks in a fast-paced environment.