Financial Counselor

Job Summary

The Financial Counselor is responsible for the timely and accurate follow-up and resolution of unpaid patient balances. This position manages a high volume of patient interactions related to self-pay accounts, analyzes patient responsibility, obtains and verifies insurance information, establishes payment arrangements, and processes patient payments. The Financial Counselor serves as a billing representative, resolving patient financial concerns that may impact a patient’s ability to receive services.

Key Responsibilities

• Respond to a high volume of incoming patient calls related to self-pay statements, billing inquiries, and payment concerns.
• Initiate outbound collection calls to patients on an ongoing basis in a professional and customer-focused manner.
• Review and monitor assigned accounts and collection reports to ensure timely follow-up and resolution.
• Analyze self-pay balances to determine patient financial responsibility, including deductibles, coinsurance, and contractual discounts.
• Establish and monitor payment arrangements and provide timely follow-up on agreed payment plans.
• Process patient payments accurately and in accordance with company procedures.
• Research accounts deemed potentially non-collectible and prepare them for referral to collection agencies as appropriate.
• Ensure all available payment resources have been researched and exhausted prior to escalation.
• Identify billing issues requiring further review (e.g., claim corrections, appeals) and communicate findings to appropriate billing staff through documented patient cases.
• Handle billing loop calls and respond to inquiries from patients, physician offices, and insurance companies.
• Resolve patient billing problems while maintaining excellent customer service and preserving patient relationships.
• Address patient concerns in a calm, courteous, and professional manner, including interactions with dissatisfied patients; escalate concerns to the Quality Department as needed.
• Meet established productivity metrics and key performance indicators (KPIs).
• Maintain compliance with HIPAA and all company plans, policies, and procedures set forth by Orthopaedic Solutions Managemet.
• Perform reports, projects, and other duties as assigned.

Education and Experience

• High School Diploma or GED required.
• Minimum of 5 years of prior medical billing experience or equivalent required.
• Working knowledge of CPT and ICD-10 coding required.
• Demonstrated understanding of Explanation of Benefits (EOBs) and reimbursement practices, including deductibles, coinsurance, and contractual adjustments.

Preferred Qualifications & Skills

• Strong knowledge of insurance guidelines and payer requirements.
• Excellent customer service skills with the ability to handle sensitive financial conversations.
• Strong attention to detail with a high level of accuracy.
• Effective verbal and written communication skills.
• Ability to work independently with minimal supervision while meeting goals, deadlines, and performance metrics.
• Ability to manage multiple tasks in a deadline-driven environment.
• Professional, well-presented, and tactful demeanor.
• Ability to work collaboratively as part of a team and meet the expectations of internal and external customers.

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.