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Healthcare Financial Consultant

2 months ago

College Station, Texas, United States CAPROCK EMERGENCY, LLC Full time
Job Overview

Position Summary:

The Financial Counselor plays a crucial role in ensuring that patients have a seamless financial experience by guiding them through the complexities of insurance benefits and potential financial responsibilities. This position serves as the primary contact for patients seeking financial assistance and support.

Reporting Structure: This role reports directly to the Director of Business Services, who is responsible for overseeing the achievement of departmental goals and objectives.

Qualifications:

  • High School Diploma or GED equivalent, with the ability to provide proof of completion.
  • A minimum of 3 years of experience in the healthcare sector or equivalent educational background.
  • Proven experience in credit, collections, and billing within a healthcare environment, preferably in a hospital.
  • Familiarity with operating personal computers and office equipment is essential.
  • Ability to interpret billing manuals and insurance policies.
  • Knowledge of the third-party review process and payer funding protocols.
  • Understanding of government and state payer eligibility criteria.
  • Familiarity with medical and insurance terminology is required.

Key Responsibilities:

  • Act as the primary point of contact for financial inquiries, engaging with patients and their families to gather relevant financial, social, and medical information.
  • Evaluate patients' current financial situations by verifying insurance benefits and confirming coverage.
  • Provide guidance on patients' financial responsibilities and explain insurance benefits clearly.
  • Assist patients in understanding their out-of-pocket costs and facilitate the collection of deductibles and outstanding balances.
  • Support patients and their families in accessing available funding sources, including private and governmental programs.
  • Initiate financial screening processes to determine eligibility for assistance programs and help patients complete necessary documentation.
  • Coordinate with physician offices to ensure pre-authorization and referral requirements are met.
  • Communicate financial coverage statuses and decisions effectively to all relevant parties.
  • Review and interpret explanations of benefits from payers to assist patients in understanding claims processing.
  • Work collaboratively with the billing department to resolve any disputed billing issues.
  • Maintain accurate patient demographic information and provide estimates for elective procedures.
  • Ensure all patient interactions are handled with professionalism and courtesy.
  • Participate in team meetings and contribute to departmental goals and staff development.
  • Adhere to company policies and comply with all applicable laws and regulations.

Skills and Abilities:

  • Strong listening and communication skills, with a focus on professionalism and respect.
  • Ability to maintain composure in high-stress situations and demonstrate empathy towards patients.
  • Excellent organizational skills to manage multiple priorities effectively.
  • Proficient in data entry and familiar with Microsoft Office applications.
  • Ability to make independent decisions and problem-solve effectively.
  • Attention to detail and accuracy in all tasks.

Physical Requirements:

  • Regularly required to communicate verbally and in writing; frequently required to sit, stand, and walk.
  • Occasionally required to lift and move objects up to 25 lbs.
  • Must be able to work in environments that may involve exposure to hazardous materials.