Financial Counseling Representative

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Work Shift: 8 Hours - Day Shifts (United States of America) Scheduled Weekly Hours: 40 Compensation: Salary Range: $17.75 - $28.00 Union Position: No Department Details Summary The Financial Counseling Representative provides financial counseling to assist patients in understanding their financial responsibility to Sanford and to offer appropriate resources and options to meet that responsibility. Job Description Answers billing questions. Reviews patient's insurance coverage and Explanation of Benefits (EOBs). Provides clarification regarding what charges were incurred and why they were incurred. 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 what copayments are, what services are covered, effective dates of coverage, when a referral is needed and the effect on insurance, how to obtain a valid referral and resubmit the claim, and how effective dates of coverage influence insurance payments. May assist patient in filling out medical assistance program paperwork, as well as referrals to Medicaid or other insurance aid or disability programs. Frequently 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 with them while also 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. Computer skills sufficient to operate on-line systems and complex software with advanced functionality. Oral and written communication skills sufficient to interpret and apply policies and procedures for clarification and problem resolution. Knowledge of third party payers and basic bookkeeping or accounting principles is required. Requires a thorough understanding of insurance products and the ability to accurately read 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. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call View phone number on click.appcast.io or send an email to View email address on click.appcast.io. The Sanford organization owns and manages multiple distinct brands, including Sanford Health, Marshfield Clinic, and Good Samaritan, as well as Lewis Drug, Sanford Health Equip, Solutions by Sanford, Great Shots, and Blue Rock Bar & Grill. Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Headquartered in Sioux Falls, South Dakota, the organization has 53,000 employees and serves over 2 million patients and nearly 425,000 health plan members across the upper Midwest including South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin and the Upper Peninsula of Michigan. The integrated nonprofit health system includes a network of 56 hospitals, 288 clinic locations, 147 senior care communities, 4,000 physicians and advanced practice providers and nearly 1,500 active clinical trials and studies. The organization’s transformational virtual care initiative brings patients closer to care with access to 78 specialties. Learn more about Sanford Health’s commitment to shaping the future of rural health care across the lifespan at sanfordhealth.org or Sanford Health News. Good Samaritan, one of the nation’s largest nonprofit providers of senior care and services, is committed to transforming the aging experience through innovation, compassion and personalized care. As part of Sanford Health, an integrated nonprofit health system headquartered in Sioux Falls, South Dakota, Good Samaritan serves 10,000 seniors and offers access to a full continuum of care, including 94 rehabilitation and skilled nursing centers, 56 assisted living and memory care facilities, 44 independent living locations and 37 home health and hospice agencies. The senior care provider delivers services across the upper Midwest, with 70% of residents living in rural communities. Learn more about Good Samaritan’s mission and commitment to delivering high quality senior care in rural America at good-sam.com.