Patient Financial Counselor

Job Summary:

The Financial Counselor serves as the primary resource for patients regarding the financial aspects of behavioral health services. This position is responsible for providing compassionate, accurate, and confidential financial counseling throughout the patient care continuum. Responsibilities include verifying insurance eligibility and benefits, educating patients about anticipated financial responsibility, assisting with payment arrangements and financial assistance programs, supporting Medicaid application processes, and managing patient account follow-up to promote timely payment while maintaining a patient-centered approach.

The Financial Counselor works collaboratively with Registration, Clinical, Billing, and Leadership teams to ensure accurate patient information, maximize reimbursement, reduce bad debt, and help patients understand and meet their financial obligations without creating barriers to medically necessary behavioral health care.

Education & Experience Qualifications:

• High school diploma or equivalent required; Associate's degree in Business, Healthcare Administration, Finance, or related field preferred.
• Two or more years of experience in healthcare registration, patient financial services, medical billing, insurance verification, or revenue cycle operations.
• Must become certified by the State of Vermont as a Medicaid Assister withing 6 months of accepting this role.
• Experience working with commercial insurance, Medicare, and Medicaid.

Knowledge, Skill, Ability Qualifications:

• Ability to manage multiple priorities while meeting deadlines.
• Excellent written and verbal communication skills.
• High level of accuracy and attention to detail.
• Ability to work independently while collaborating effectively with cross-functional teams.
• Strong customer service and communication skills.
• Ability to explain complex financial information with empathy and professionalism.
• Strong organizational skills with attention to detail.
• Proficiency with electronic health records, patient accounting systems, and Microsoft Office applications.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Core Leadership Standards & Competencies

• Verify insurance eligibility, benefits, authorizations, and coverage prior to or at the time of service.
• Calculate and communicate anticipated patient financial responsibility, including deductibles, copayments, coinsurance, and non-covered services.
• Clearly explain insurance benefits and billing processes in a respectful, patient-friendly manner.
• Document all financial discussions and payment arrangements in the electronic health record and/or patient accounting system.
• Discuss available payment options with patients and responsible parties.
• Collect patient payments prior to time of service whenever possible.
• Establish payment plans in accordance with organizational policies.
• Assist eligible patients with applications for Medicaid or other governmental assistance programs.
• Screen patients for charity care or financial assistance eligibility and assist with the application process.
• Monitor pending financial assistance applications and follow up as necessary.
• Respond to patient questions regarding existing balances, billing statements, insurance payments, and payment options.
• Review patient accounts to identify outstanding balances requiring follow-up.
• Perform courteous, service-oriented collection calls on delinquent accounts while maintaining compliance with all applicable laws and organizational policies.
• Work with patients to resolve outstanding balances through payment arrangements or available financial assistance programs.
• Escalate complex billing concerns to appropriate departments when necessary.