The Financial Counselor III provides financial guidance and support to patients by reviewing insurance coverage, estimating patient financial responsibility, and assisting with payment arrangements and financial aid applications. The Financial Counselor III is responsible for the daily operations within the department. Responsible for coaching employees, monitoring progress, enforcing rules, and ensuring quality compliance. Responsible for guiding, training, and supporting their team members and needs to be highly motivated to inspire employees to own their work and deliver better results.
Essential Responsibilities
Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.
Review EMR and visit in-house patients to collect estimated patient portion amounts.
Obtain and verify patient insurance information and update medical records accordingly.
Provide financial counseling to patients - explaining insurance benefits, payment options, and financial responsibilities.
Assist patients with payment arrangements, charity applications, and Medicaid/state aid applications.
Monitor and maintain patient financial status to ensure accounts are within acceptable limits.
Post Emergency Room and Patient Access deposits into the system.
Enter insurance information into EMR and update system notes.
Provide estimates to patients and physicians as requested.
Coordinate with case management and insurance verification departments for concurrent certification.
Receive and receipt payments in accordance with internal cash control procedures.
Assist patients with obtaining financial resources for prescriptions through pharmaceutical grants and aid programs.
Act as a patient advocate when communicating with insurance carriers or financial institutions.
Review outstanding insurance claims and coordinate follow-up with billing staff.
Prepare medical necessity letters and process related documentation.
Maintain insurance files and stay updated on changes.
Diffuse minor issues and escalate major concerns to senior leadership.
Maintain professional image and deliver excellent customer service.
Attend mandatory training and demonstrate knowledge of safety and compliance protocols.
Staffs and orders supplies according to budget guidelines and department needs.
Assists with the processing of payroll for team members by maintaining employee edit requests and PTO requests.
Maintains accurate attendance records for employees.
Maintains QA statistics (including patient wait times) and reports results to management.
Assists and provides input on employee quarterly performance reviews.
Oversees daily activities of Financial Counseling areas to ensure department standards are met.
Provides coverage during staff absences as needed.
Secures necessary signatures for treatment, release of information, insurance benefits, and payment.
Reviews daily pre-service log to ensure account activation.
Updates collection system and requests rebills when appropriate.
Collects and requests deposits and copays.
Assumes on-call responsibilities to ensure adequate staffing and problem-solving.
Registers all patient types as needed.
Schedules and assists with evaluations; resolves patient and employee concerns.
Ensures compliance with personnel and department policies and procedures.
Acts in the capacity of Manager in their absence and communicates issues upon their return.
Supervises and maintains effective patient flow.
Recommends a sufficient number of qualified and competent staff.
Determines staff qualifications and competence; maintains competency checklists and attestation forms.
Attends in-service presentations and completes mandatory education including infection control, patient safety, and OSHA standards.
Utilizes occurrence reporting system to report potential patient safety issues.
Seeks ways to control costs without compromising patient safety or service quality.
Excels in all functions performed by Patient Access staff.
Collaborates with nursing and ancillary departments to maintain a teamwork approach.
General Responsibilities
Performs other duties as assigned.
Minimum Qualifications
Education Requirements
Associate's Degree required.
Experience Requirements
5 or more years of experience in Patient Access, healthcare, or billing required.
License/Certification/Registration Requirements
Certified Revenue Cycle Representative (CRCR) issued by the Healthcare Financial Management Association (HFMA), or Certified Healthcare Financial Professional (CHFP) issued by HFMA required within 180 days of hire.
Knowledge/Skills/Abilities Requirements
Organization: Proactively prioritizes needs and effectively manages resources.
Communication: Possesses strong communication skills and resolves workplace issues effectively.
Leadership: Guides individuals and groups toward desired outcomes, setting high performance standards.
Customer Orientation: Builds long-term customer relationships by consistently exceeding expectations.
Interpersonal Skills: Works effectively with employees, patients, and external parties.
Policies & Procedures: Understands and articulates organizational policies and systems.
PC Skills: Proficient in Microsoft Office and other required applications.
Financial Management: Applies tools and processes to successfully manage budget.
Essential Physical Functions of the Job
Employees must be able to perform the following physical activities with or without accommodations
Stand for (0) hours per day
Sit for (8) hours per day
Walk for (0) hours per day
Job Requires Continuous
Hear Normal Speaking and Alarms
Visual Acuity (20/50)
Job Requires Occasional
Fine Motor Skills
Continuous Potential Hazards/Exposures
Repetitive Motions