Financial Counselor

About the role

The Financial Counselor acts as the liaison between patients and the practice, coordinating payments, assisting patients, monitoring balances and keeping insurance benefits current in the electronic medical records and billing software. The role also performs quality control for pre-certification and prior authorization. It is based at Bay Hematology Oncology, with standard hours Monday to Friday 8:00 AM to 5:00 PM and occasional overtime.

Key responsibilities

• Coordinate with insurers on pre-certification and prior authorization, including peer-to-peer requests and appeals
• Review patient and physician schedules and treatment plans to confirm active insurance coverage and patient responsibility
• Review new treatment orders, estimate costs and explain insurance benefits and out-of-pocket costs to patients
• Identify aging balances and arrange payment plans or assistance applications
• Help patients complete paperwork for assistance programs and grants, and coordinate with the financial aid counseling team
• Communicate daily with providers, nursing staff, PSS staff and the UM team about financial matters
• Work with outside entities to complete forms and paperwork in a timely way
• Comply with federal and state laws on patient care, rights, safety, billing and collections, and follow AON revenue cycle policies

Required profile

• High school diploma or GED; further education or a degree is a plus
• At least two years of prior healthcare experience, preferably in a clinical or business office setting
• Prior healthcare customer service, medical terminology, insurance verification and pre-certification/prior authorization experience
• Cash handling and collection experience, and ability to calculate patient responsibility, co-pays and coinsurance
• Good verbal and written communication skills; second language is an asset
• Ability to work independently, manage competing priorities and work remotely when required

Required skills

• Proficiency in MS Office Word, Excel, PowerPoint and Outlook
• Understanding of medical terminology, ICD-9, ICD-10 and CPT codes
• Ability to use multiple screens and switch between applications