PATIENT FINANCIAL COUNSELOR

Job Description

Job Description

POSITION SUMMARY

The Financial Counselor help patients understand and access financial assistance programs like Medicaid and sliding fee scales, assist with applications, and provide education on healthcare costs to ensure equitable access to care for vulnerable populations. This position ensures accurate verification of benefits, grant eligibility, and authorization from third-party payers for services rendered. Certified as Application Counselors (CAC), they help patients enroll in Medicaid and Marketplace plans while ensuring accurate account information and compliance with CCHS policies. The financial counselor will ensure all patients are financially cleared and screened for financial risk before receiving services.

Key Responsibilities

• Verifies insurance eligibility and benefits, and ensures appropriate authorizations are obtained when applicable for clinic procedures. Record all payer communications, reference numbers, and authorization details in patient records promptly and accurately.
• Accurately process patient sliding fee applications as they relate to Federal Poverty Guidelines offered by CCHS and provide cost of care estimates when needed. • Assists uninsured patients to help navigate their insurance options and eligibility in programs such as, A Step Ahead Foundation Program, Ryan White Program and Tennessee Breast and Cervical Screening Program (TBCSP).
• Reviews aged accounts receivable balances for self-pay patients. Initiate and manage outreach to patients with self-pay balances, working to establish and document payment arrangements.
• Serves as a Certified Application Counselor (CAC) by assisting patients and families with Medicaid and Marketplace applications, renewals, and eligibility determinations. Provide patients with step-by-step guidance throughout the enrollment process. Tracks patient application status and provide ongoing support until enrollment is complete.
• Actively work to transition self-pay patients into Medicaid or other eligible coverage programs to reduce patient out-of-pocket burden and financial risk to CCHS.
• Performs all other duties assigned by management.

POSITION REQUIREMENTS

Education

• Associate or bachelor’s degree in health services, Business Administration, Healthcare Administration or related field, or equivalent experience preferred.

Experience

• 1-3 years of experience in financial counseling or healthcare registration, billing, collections, or a related field required.
• Working knowledge of insurance providers, their portals, and their expectations for authorization approvals.

Licenses or Certification

• Complete the Certified Application Counselor (CAC) certification exam within 90 days of hire.

Knowledge, Skills, and Abilities

• Maintain regular work schedule and reliable attendance and be punctual: Monday through Friday, 8:00am to 5:00pm
• Excellent computer and keyboarding skills, including familiarity with Windows
• Excellent verbal and written communication skills.
• Strong customer service skills.
• Ability to read, write and comprehend the English language.
• Ability to effectively maintain confidentiality of records and communicate with all levels of personnel.
• Responds to patient inquiries regarding account balances, billing concerns, and insurance coverage; returns all patient calls in a timely and professional manner.
• Must have knowledge of Medicare, TN Medicaid, Commercial, and Sliding Fee payment methods.
• Maintain knowledge of Federally Qualified Health Center (FQHC) policies, procedures, and compliance requirements to ensure all financial counseling, billing, and enrollment activities align with federal and organizational standards.
• Must be able to exercise independent judgment and make sound decisions.
• Prolonged periods of being stationary at a desk and working on a computer.

Working Conditions

Office environment and clinic setting with some exposure to individuals with potentially contagious infections; low-moderate risk of injury