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.
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.
