Financial Counselor

Bargaining Unit: EA

Rate of Pay: $32.20/hour + DOE

Summary
The Financial Counselor is part of the Financial Navigation team and serves as an advanced patient advocate, guiding patients through the financial aspects of their healthcare journey. This role provides education regarding healthcare costs, insurance benefits, payment options, and financial assistance programs while assisting patients with financial planning and access to care. The Financial Counselor is responsible for financial clearance activities, including reviewing high-dollar liabilities, discussing financial obligations, securing payment arrangements, and helping patients access financial resources.

Essential Duties and Responsibilities

• Serves as a primary resource for patients regarding healthcare costs, insurance benefits, financial responsibility, payment options, and financial assistance programs.
• Perform all Financial Navigator responsibilities, including patient financial education, estimate communication, insurance benefit review, payment plan setup, and account resolution.
• Create and communicate patient financial estimates for scheduled and prospective services. Verify insurance eligibility, benefits, coverage limitations, and patient responsibility.
• Educate patients regarding healthcare costs, deductibles, copayments, coinsurance, out of pocket expenses, and factors that may affect final patient liability.
• Serves as a primary resource for patients regarding healthcare costs, insurance benefits, financial responsibility, payment options, and financial assistance programs.
• Perform all Financial Navigator responsibilities, including patient financial education, estimate communication, insurance benefit review, payment plan setup, and account resolution.
• Create and communicate patient financial estimates for scheduled and prospective services. Verify insurance eligibility, benefits, coverage limitations, and patient responsibility.
• Educate patients regarding healthcare costs, deductibles, copayments, coinsurance, out of pocket expenses, and factors that may affect final patient liability.
• Identify patients with financial barriers to care and connect them with available financial resources and assistance programs.
• Screen patients for eligibility and assist with enrollment in Medi-Cal, Medicaid, Financial Assistance, Grants, and other available financial programs.
• Complete Medi-Cal and Medicaid application processes, including patient screening, collection of supporting documents, application submission, and follow-up with county agencies regarding eligibility determination.
• Meet with patients in outpatient, emergency, inpatient, and other care settings to discuss estimates, benefits, financial responsibility, payment options, and financial assistance opportunities.
• Financially clear patients prior to services according to organizational policy.
• Review and address patients with financial responsibility exceeding established organizational thresholds, including balances greater than $5,000, by communicating financial obligations, discussing available options, and obtaining financial clearance prior to services whenever applicable.
• Collect required deposits and secure payment arrangements prior to service as appropriate.
• Assist patients in understanding insurance authorization requirements, coverage restrictions, and benefit limitations that may impact financial responsibility.
• Conduct inbound and outbound calls related to estimates, financial clearance, financial assistance, account balances, payment arrangements, and account resolution.
• Establish payment plans and prepare related patient communications and documentation.
• Collect and accurately post patient payments.
• Research and resolve complex patient billing, insurance, and account concerns through collaboration with internal and external stakeholders.
• Work closely with Patient Financial Services, Patient Access, Scheduling, Authorizations, Case Management, Nursing, Patient Advocacy, providers, physician offices, and payers to resolve financial and insurance-related barriers to care.
• Respond to requests from staff to assist patients with complex financial concerns and financial clearance needs.
• Complete assigned work queue activities and maintain productivity standards.
• Process Financial Assistance applications and ensure timely follow-up and determination.
• Review bad debt notices, bankruptcy documentation, and related financial records and process according to organizational policy.
• Enter and follow up on patient complaints related to financial matters and coordinate resolution as appropriate.
• Maintain accurate documentation of all patient interactions within the Electronic Health Record (EHR) and other applicable systems.
• Utilize interpreter services as necessary to ensure effective communication.
• Assist patients through phone, MyChart, email, written correspondence, and in-person interactions.
• Verify and route financial inquiries received through departmental communication channels.
• Participate in departmental quality initiatives, audits, reporting activities, and process improvement efforts.
• Identify trends and barriers related to patient affordability, financial clearance, financial assistance utilization, and access to care.
• Assist with training, mentoring, and education of Financial Navigators and other staff regarding financial assistance, financial clearance, and patient financial advocacy.
• Maintain required certifications, continuing education, and competency requirements.
• Adhere to all organizational policies, regulatory requirements, confidentiality standards, and customer service expectations.
• Demonstrate organizational values and commitment to providing an exceptional patient financial experience.
• Perform other duties as assigned.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Supervisory Responsibilities
No supervisory responsibilities.

Minimum Education/Experience
6 months to 1 year relevant experience

Required Licenses/Certifications
AAHAM Certified Revenue Cycle Specialist (CRCS)

• Within 1 year of hire into job

Other Experience/Qualifications

Preferred

• Strong aptitude with Microsoft Access
• Utilizes computer system and its features
• Bachelor of Arts Degree
• One to two years’ experience working with public and experience in patient registration and/or hospital patient accounting office

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.