Financial Counseling Representative

Responsibilities Answers billing questions. Reviews patient’s insurance coverage and Explanation of Benefits (EOBs). Provides clarification regarding what charges were incurred and why. Reviews insurance denials and provides an explanation for the denial to the patient. Reviews payment plan guidelines and assists in setting up payment arrangements. Determines if patient is eligible for payment‑assistance programs and assists in the application process, if applicable. Educates patients regarding insurance concepts, such as copayments, covered services, effective dates of coverage, referral requirements, and how effective dates influence insurance payments. May assist patient in filling out medical‑assistance program paperwork and referrals to Medicaid or other insurance aid or disability programs. Frequent advises uninsured patients on outstanding medical costs associated with procedures performed in a clinic setting and establishes a payment plan. Interacts with patients in‑person and must be able to empathize while diffusing strong emotions. Calculates and provides cost estimates for medical procedures, including the patient’s anticipated share. Advises on and collects prepayments for services not covered by insurance. May perform guest‑service duties as needed. Other duties as assigned. Operates on‑line systems and complex software with advanced functionality. Utilizes oral and written communication skills to interpret and apply policies and procedures for clarification and problem resolution. Has knowledge of third‑party payers and basic bookkeeping or accounting principles. Accurately reads an EOB to determine what adjustments have been made, what payments have been received, and calculate pending balances. Qualifications High school diploma or equivalent preferred. Post‑secondary education preferred. Two years’ experience in healthcare service or health insurance preferred. Sanford is an EEO/AA Employer M/F/Disability/Vet. #J-18808-Ljbffr 10000 Sanford