Patient Financial Counselor

Pay Range: $26.00 - $28.00 per hour

About PGA

Portland Gastroenterology Associates (PGA) is a physician-owned gastroenterology practice serving patients across southern Maine. Our team of physicians, nurses, and support staff provides expert, caring digestive health services, including screening and diagnostic procedures. We take pride in clear communication, respect for every patient, and a culture where colleagues help each other do their best work.

The Role

As a Patient Financial Counselor, you will help patients understand their insurance benefits and what they may owe before and after their care. You will explain terms like deductibles, copayments, and coinsurance in plain language, prepare cost estimates, and set up payment options. You will work closely with our Billing, Scheduling, Clinical, and Front Desk teams so patients get clear and consistent answers. This role reports to the Billing Manager and follows a hybrid work model.

What You'll Do

Help Patients Understand Their Insurance

• Explain insurance terms such as deductibles, copayments, coinsurance, out-of-pocket maximums, and in-network versus out-of-network benefits.
• Explain the difference between screening and diagnostic procedures and how each may affect cost.
• Make clear that benefit information and estimates are not a guarantee of payment.
• Point patients to their insurance carrier when they need a final decision on coverage.
• Support patients who are uninsured, underinsured, or confused about their coverage.

Prepare Estimates and Discuss Payment Options

• Prepare patient-specific estimates for scheduled services and procedures, including Good Faith Estimates.
• Explain what a patient may owe, including deductibles, copayments, coinsurance, and self-pay amounts.
• Set up payment arrangements and payment plans within practice guidelines.
• Share financial assistance or payment options when they apply.

Complete Financial Clearance Before Visits

• Review upcoming appointments and procedures for insurance and financial needs.
• Find missing, expired, or incorrect insurance and demographic information and pass it to the right team.
• Flag needs for referrals, records, or prior authorization.
• Follow up on open issues before the appointment or procedure.

Help With Balances and Accounts

• Explain charges, insurance payments, adjustments, denials, and remaining balances.
• Refer accounts to Billing, Coding, or the insurance carrier when more review is needed.
• Accept and process patient payments following practice procedures.
• Send complex or unusual situations to the Billing Manager.

Stay Current and Keep Good Records

• Keep up to date on commercial plans, Medicare, Medicare Advantage, and Medicaid, including carrier rules on screening ages and time intervals.
• Answer patient questions by phone, portal, email, or in person.
• Document each patient conversation, estimate, and payment arrangement in our systems.
• Protect patient privacy and follow HIPAA at all times.
• Help improve upfront collections, patient education materials, and the overall patient financial experience.

What We're Looking For

Required

• High school diploma or equivalent.
• At least three years of experience in at least three of these areas: medical office, health insurance, medical billing, prior authorization and referrals, patient financial services, commercial insurance, Medicare, Medicare Advantage, and Medicaid, or a closely related setting.
• Strong understanding of basic health insurance terms and medical billing concepts.
• Excellent customer service and communication skills, including the ability to explain complex information simply.
• Strong attention to detail and accurate documentation.
• Ability to handle sensitive financial information and protect patient confidentiality.
• Comfort using computers, electronic medical records, practice management systems, and standard office software.

Preferred

• Bachelor's degree in a related field.
• Five years of experience in medical billing, insurance verification, patient financial counseling, or revenue cycle work.
• Certified Professional Coder (CPC) credential, or experience with medical coding rules.
• Experience preparing medical estimates or Good Faith Estimates.
• Experience in a specialty medical practice.
• Certification in healthcare access, insurance navigation, or medical billing.
• Non-exempt (hourly) position with a hybrid work schedule.
• Office setting with regular sitting, standing, and walking. Occasional lifting of up to 25 pounds.
• Conversations about money can be sensitive. You will stay calm, kind, and professional.

Why PGA?

You will be part of a team that values accountability, compassion, excellence, integrity, inclusion, and sustainability. Your work will help patients feel informed and supported at a time when costs can feel confusing. We offer a competitive hourly rate , a hybrid schedule, and a chance to help shape how our patients experience the financial side of care.

Electronic Monitoring Notice

Portland Gastroenterology Center uses electronic monitoring of its computers, phones, and systems to protect patient privacy, keep systems secure, and follow the law. Phone calls on our phones are recorded. We will explain this during the interview process, and employees receive a written notice every year.

Portland Gastroenterology Center is an equal opportunity employer. We welcome applicants of all backgrounds, and we make hiring decisions without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other status protected by law. We provide reasonable accommodations for applicants with disabilities.