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.