Cancer, Co-Payments, Communication Skills, Cost Estimates, Detail Oriented, Documentation, Finance, Financial Analysis, Financial Management, Financial Planning, Financial Services, Financial Systems, Financial Transactions, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Healthcare, Hospital, Interpersonal Skills, Maintain Compliance, Medical Billing, Medical Office, Medical Record System, Medicine, Microsoft Office, Multitasking, Patient Education, Record Keeping, Regulatory Compliance, Regulatory Requirements
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.