RCM - FINANCIAL COUNSELOR

The Financial Counselor is responsible for providing cost estimates to patients prior to their appointments. This role supports patients in understanding their insurance coverage and financial responsibility by determining eligibility, benefits, and expected reimbursement amounts.

The Financial Counselor performs insurance verification, calculates and communicates out-of-pocket costs, secures payments in advance of services, and ensures appropriate coverage is in place. This position requires the ability to interpret and clearly explain complex financial and insurance information while delivering a high level of customer service.

Key Responsibilities:

• Answer incoming phone calls, emails, and messages in a courteous and professional manner.

• Deliver accurate cost estimates to patients prior to scheduled appointments.
• Assist patients with payment arrangements and financial assistance applications.
• Educate patients on available financial assistance options and clearly explain the financial impact of each.
• Serve as a liaison between patients and the practice to ensure charges are applied correctly, transactions are properly recorded, and account discrepancies are resolved in a timely manner.
• Generate daily insurance verification reports and confirm patient eligibility.
• Utilize eligibility systems, payer websites, and phone communication to verify insurance benefits and coverage details.
• Accurately enter and maintain patient insurance information in appropriate systems.
• Document all interactions and updates in the appropriate electronic systems (EHR/EMR).

• Participate in special projects and perform additional duties as assigned.

Job Expectations:

• Communication: Demonstrate strong communication skills when explaining complex financial and insurance information. Work collaboratively with clinical, billing, and administrative teams.
• Accuracy: Ensure all account notes and updates are entered correctly in the system.
• Compliance: Follow all internal procedures and external regulations (FDCPA, HIPAA, etc.).
• Teamwork: Collaborate effectively with peers and leadership to resolve patient issues and improve processes.