Patient Access Rep Financial Counselor TMCH Cancer Center Orange Grove

Patient Access Rep - Financial Counselor

The Patient Access Rep - Financial Counselor is responsible for assisting patients and their families in understanding and managing the financial aspects of their healthcare. This includes verifying insurance coverage, estimating out-of-pocket costs, arranging payment plans, and identifying financial assistance programs. The role ensures compliance with hospital policies and regulatory requirements while delivering compassionate and informed support to patients.

Essential Functions:

• Interview patients or their representatives to assess financial status and determine payment options.
• Verify insurance eligibility, benefits, and authorization requirements.
• Provide cost estimates and explain patient financial responsibility.
• Collect deposits, co-pays, and deductibles; establish and monitor payment plans.
• Assist patients in applying for financial assistance, charity care, or third-party funding.
• Ensure completion of financial documentation in accordance with hospital policies.
• Perform medical necessity screening and ensure compliance with system requirements.
• Collaborate with clinical departments and physician offices to obtain necessary documentation.
• Maintain accurate records and documentation in EHR and financial systems.
• Prepare daily deposits and reconcile financial transactions.
• Adhere to HIPAA and organizational confidentiality standards.
• Performs related duties as assigned.

Minimum Qualifications

Education: High school diploma or GED required; associate degree or vocational training in healthcare or finance preferred.

Experience: Three (3) years in a healthcare or medical office setting, including experience in insurance verification, financial counseling, or patient access.

Licensure or Certification: None required; CHAA or related certification preferred.

Knowledge, Skills, and Abilities:

• Knowledge of healthcare billing, insurance plans, and financial assistance programs.
• Strong interpersonal and communication skills.
• Ability to explain complex financial information in a clear and compassionate manner.
• Proficiency in EHR systems, payer portals, and Microsoft Office.
• Attention to detail and accuracy in documentation.
• Ability to manage multiple tasks in a fast-paced environment.