AddressNavigating the finances of healthcare is an overwhelming endeavor. Financial Counselors (FCs) will help patients navigate and understand this arena, in so doing, will reduce stress around the financial responsibility of their episode of care. This role is also critical for maintaining the financial health of the organization, by managing front-end insurance and revenue cycle processes.
GENERAL SUMMARY:
Under minimal supervision, Financial Counselors:
· Review patient's financial state, counsel patients on their out-of-pocket cost for their treatment plan, advise on insurance optimization options, and connect patient to financial assistance programs available to them.
· Perform any medical necessity reviews for treatment, prior to treatment, and work closely with the central authorization team to ensure the coordination of the medical necessity and authorization process.
· For off-label usages, FCs will be the point person for the appeal process and work towards a solution with the clinical team and payer.
· Be the point person for the clinical team regarding financial implications of their patient's care.
· Must be critical thinkers, who are skilled at problem solving and thinking through complex situations.
EDUCATION REQUIRED:
· Bachelor's degree or five plus (5+) years of experience in related field required.
EXPERIENCE REQUIRED:
· Experience in healthcare billing or related field required.
· In-depth knowledge of health insurance required.
· Pharmacy Tech Experience preferred.
· Proficiency in EPIC applications such as:
o Appointment Scheduling (all versions),
o Registrations,
o Work Queues
o and Referrals, preferred.
· Customer service-oriented including the ability to interact professionally and handle sensitive information/issues in a confidential, respectful, assertive, and empathetic manner in difficult interpersonal situations.
· Acts in a manner that establishes positive rapport with patients, families, and public/private financial assistance programs.
· Ability to quickly assess and respond appropriately to emergency situations.
· Ability to comprehend medical terms.
· Analytical skills to resolve complex problems requiring the use of scientific, mathematical, or technical principles, and in-depth experience in multi-tasking.
· Ability to deliver consistent results and possess the drive to continually improve processes to benefit the patient and the hospital system.
· Ability to visually proofread typed work for errors.
· Ability to communicate via telephone to a variety of groups (patients, patients' families, insurance companies, other departments, etc.).
