AWHS Medical Financial Counselor Job Description

Job Summary:

The Medical Financial Counselor position serves as a primary contact to educate families and individual patients about insurance and patient financial responsibilities. The Patient Financial Counselor conducts all interactions in a manner that result in a positive patient experience and full patient understanding of their financial responsibilities and options.

Reports to: Practice Administrator.

FLSA Status: Non-Exempt.

Essential Duties/Responsibilities:

• Provide welcoming, professional customer service to patients, families, and visitors.
• Complete patient pre-registration, admission, demographic, insurance, and consent processes.
• Verify insurance coverage and accurately enter patient information into the EMR.
• Explain insurance benefits, patient financial responsibilities, charges, and payment policies.
• Calculate, collect, and document patient payments and financial obligations.
• Establish payment arrangements and monthly installment plans in accordance with organizational policies.
• Follow up on outstanding balances, including collection calls, letters, and payment arrangements.
• Document all account activity, communications, payments, and follow-up actions in the appropriate systems.
• Assist self-pay patients with financial assistance options and maintain required documentation.
• Submit bad debt accounts and maintain communication with collection agencies.
• Respond to patient inquiries by phone and email and resolve concerns professionally.
• Support financial reporting, departmental productivity, and other administrative functions as assigned.
• Promote the organization’s mission, vision, values, and positive public relations.

Required Knowledge/Skills/Abilities:

• Strong knowledge of ICD-9-CM, ICD-10, CPT, HCPCS, and healthcare reimbursement methodologies.
• Knowledge of third-party insurance plans, including HMO, POS, PPO, Indemnity, and Medicare Parts A & B.
• Knowledge of medical terminology, healthcare policies, procedures, and reimbursement practices.
• Proficiency with EMR systems; experience with Epic preferred.
• Proficiency with Microsoft Office and general administrative and clerical procedures.
• Strong customer service skills with the ability to communicate financial responsibilities, resolve patient concerns, and assist with payment solutions.
• Strong analytical and problem-solving skills with the ability to research information, interpret policies, and resolve issues independently.
• Excellent verbal, written, and interpersonal communication skills.
• Strong organizational skills with excellent attention to detail and ability to prioritize multiple tasks.
• Ability to maintain patient confidentiality, professionalism, and compliance with organizational policies and procedures.
• Ability to exercise sound independent judgment and work effectively both independently and as part of a team.
• Ability to build and maintain positive working relationships with patients, physicians, staff, and the public.
• Commitment to continued education, training, performance improvement, and quality improvement initiatives.
• Ability to consistently represent the organization’s mission, values, ethics, and goals in a positive and professional manner.

Education and Experience:

• High school diploma or GED required, Associates degree or higher preferred.
• 2-3 years of demonstrated experience in healthcare financial counseling and/or medical billing.
• 2-3 years of experience with strong knowledge of medical documentation, insurance verifications, third party reimbursement requirements, and financial liability calculations.
• Experience reviewing health care delivery against established guidelines, as well as knowledge of severity of illness/intensity of service review criteria.
• Preferred certification: Certified Patient Account Representative (CPAR).

Physical Requirements:

• Prolonged periods of sitting or standing at a desk and working on a computer in a stationary position. Must be able to remain in a stationary position for a prolonged period of time.
• Constantly operates a computer and other office machinery, such as a calculator, copy machine, computer printer.
• Must be able to lift up to 15 pounds at times and transport up to 15 pounds at a time over short distances.

Equal Opportunity Employer: Atlanta Women’s Healthcare Specialists is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, military or veteran status, gender, color or national origin in its employment practices.

Atlanta Women’s Healthcare Specialists participates in E-Verify to verify the authorization to work within the United States and conducts pre-employment drug screening and background checks in accordance with federal and state laws and regulations.

COVID-19 vaccine required.