Counselor

JOB SUMMARY The Financial Counselor is responsible for performing financial clearance functions including insurance verification, prior authorization review, referral validation, and patient financial counseling to ensure patients are financially cleared prior to services. This role works collaboratively with clinic staff, providers, revenue cycle teams, and payers to promote accurate financial clearance, minimize financial risk to the organization, and ensure a positive patient financial experience. The Financial Counselor must understand Revenue Cycle workflows, payer practices, utilization management, and basic coding principles to ensure accurate and timely financial clearance. ESSENTIAL JOB FUNCTIONS (Other duties as assigned) Perform benefits verification for scheduled services. Validate prior authorization requirements and ensure approvals are obtained timely when required. Review referrals for accuracy and completeness based on payer requirements. Calculate and communicate patient financial responsibility (copays, deductibles, coinsurance, non-covered services). Conduct financial counseling conversations with patients in a professional, empathetic, and compliant manner. Collect pre-service payments in accordance with organizational policies. Review accounts for potential financial assistance eligibility and guide patients through available programs when applicable. Document all verification, authorization, and counseling activity accurately within the practice management system. Maintain knowledge of payer-specific requirements, fee schedules, and coverage guidelines. Identify and elevate payer discrepancies, workflow issues, or system errors impacting financial clearance. Collaborate with Scheduling, Authorization, Charge Capture, and AR teams to ensure seamless revenue cycle workflow. Support denial prevention by ensuring accuracy of insurance selection, coverage validation, and authorization documentation. Follow established workflows to prevent under- or over-collection. Adhere to compliance standards, HIPAA regulations, contractual obligations, and the organization’s Code of Conduct. Participate in departmental meetings, training sessions, and process improvement initiatives as assigned. WORK ENVIRONMENT Fast-paced, deadline-oriented, onsite. This position is in office 40 hours per week. PHYSICAL DEMANDS The physical demands described here are representative of those required to perform the essential functions of this job. Prolonged sitting and computer use Frequent use of hands for typing and data entry Occasional standing, walking, bending, or reaching Visual acuity required for detailed computer work Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. POSITION TYPE AND EXPECTED HOURS OF WORK Full-time position. Standard business hours with flexibility based on operational needs. TRAVEL Occasional travel may be required. REQUIRED EDUCATION AND EXPERIENCE Minimum of 2–3 years of experience in healthcare revenue cycle, financial counseling, insurance verification, or related field Knowledge of insurance verification, prior authorization, referrals, and patient responsibility calculations Understanding of payer guidelines and basic coding principles Proficient in Microsoft Office (Word, Excel, Outlook) Strong data entry accuracy and attention to detail Excellent verbal and written communication skills Strong interpersonal skills with the ability to handle sensitive financial discussions professionally Ability to multitask and prioritize in a deadline-driven environment Ability to work independently in a remote or hybrid environment Strong organizational skills and time management PREFERRED EDUCATION AND EXPERIENCE Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred Experience with NextGen and eligibility platforms Experience with financial assistance programs #J-18808-Ljbffr