A Brief Overview a { text-decoration: none; color: #464feb; } tr th, tr td { border: 1px solid #e6e6e6; } tr th { background-color: #f5f5f5; } The Financial Counselor supports customer service, patient financial advocacy, counseling, and clearance activities within Care Connections and Revenue Cycle. This role helps patients understand and manage healthcare costs by providing estimates, collecting pre-service payments, reviewing insurance coverage, facilitating financial assistance and Medicaid enrollment, and arranging payment solutions.
The FC serves as a patient-facing resource, guiding patients and families through financial options while ensuring compliance with healthcare regulations, payer requirements, and UH policies. Responsibilities include financial clearance, eligibility verification, Good Faith Estimates, payment plans, pre-service collections, and support for specialty services. Working closely with patients, community agencies, insurers, internal departments, and vendors, the FC helps reduce financial barriers to care, improve access to services, and resolve account issues through outreach, reporting, and customer support activities.
The role also contributes to process improvements, analytics, patient education, and departmental initiatives.
Financial Counseling, Financial Clearance & Collections Generate patient estimates and Good Faith Estimates (GFEs) in accordance with organizational and regulatory requirements. Educate patients regarding financial responsibility, deductibles, copayments, coinsurance, and payment options. Conduct pre-service collections, financial clearance activities, and monitor self-pay accounts.
Assist patients with payment plans, financing options, and collection of down payments. Review insurance benefits and identify coverage limitations impacting financial responsibility. Counsel patients regarding out-of-network benefits, self-pay obligations, and financial considerations.
Conduct specialty-service and IVF financial counseling appointments. Process payments through approved methods. Escalate financially complex accounts for clinical, financial, or operational review.
Identify financial solutions that improve financial clearance and patient access to care. Financial Assistance & Medicaid Support Explain and determine eligibility for hospital financial assistance programs. Assist with financial assistance applications and supporting documentation.
Conduct financial hardship assessments and identify available resources. Assist with Medicaid applications, renewals, redeterminations, and eligibility verification. Serve as an Authorized Representative when appropriately designated.
Coordinate with county agencies, managed care organizations, government agencies, and community partners. Conduct presumptive eligibility screenings and support enrollment initiatives. Educate patients on available insurance, Medicaid, financial assistance, and community resources.
Customer Service & Patient Engagement Identify patient needs, research issues, and provide solutions and recommendations. Manage inbound and outbound patient financial counseling calls. Support patients with estimates, insurance coverage, payment plans, financial assistance, and billing concerns.
Conduct outreach to financially at-risk patients requiring additional support. Coordinate handoffs to Customer Service and appropriate departments. Escalate sensitive patient concerns and promote a positive patient experience through education and advocacy.
Community Outreach, Reporting & Process Improvement Participate in community outreach events, health fairs, and educational initiatives. Support efforts to improve healthcare access and reduce uninsured populations. Analyze reports, worklists, and account inventories to identify improvement opportunities.
Assist with implementation of new workflows, best practices, and departmental initiatives. Support leadership with projects, reporting, analytics, training, mentoring, and onboarding activities. Additional Responsibilities Perform other duties as assigned.
Comply with all policies, standards, and departmental procedures. Maintain confidentiality and safeguard Protected Health Information (PHI) in accordance with HIPAA, the UH Code of Conduct, and organizational policies. Maintain compliance with Good Faith Estimate requirements, No Surprises Act regulations, financial assistance regulations, CMS guidelines, Medicaid regulations, and organizational policies related to financial counseling activities.
Education High School Equivalent / GED (Required) Associate Degree in Healthcare, Business, Revenue Cycle, Social Services, Public Health, or related field (Preferred) Work Experience 3+ years experience in revenue cycle, patient access, patient financial services, healthcare reimbursement, financial counseling, or healthcare-related field (Required) Experience with medical billing software Experience with patient estimates, Good Faith Estimates, financial clearance activities, financial assistance programs, Medicaid enrollment, or eligibility programs (Preferred) Experience with pre-service collections, payment plans, and patient financial advocacy (Preferred) Knowledge, Skills, & Abilities Knowledge of managed care insurance requirements is essential (Required proficiency) Knowledge of Price Transparency, Good Faith Estimate, and No Surprises Act requirements (Required proficiency) Knowledge of Medicaid eligibility, enrollment processes, presumptive eligibility, and public assistance programs (Required proficiency) Investigative and research skills to identify financial options for patients (Required proficiency) Exceptional written and verbal communication skills (Required proficiency) Proficient with digital systems, applications, and workflow tools (Required proficiency) Advanced knowledge of medical billing and claims terminology and workflow processing (Required proficiency) Consistently demonstrates advanced analytical and problem-solving skills (Required proficiency) Exceptional client service, communication, patient advocacy, and relationship-building skills (Required proficiency) Ability to educate patients regarding insurance coverage, financial responsibility, and available financial resources (Required proficiency) Self-motivated, works independently, and consistently demonstrates the ability to perform in a fast-paced environment (Required proficiency) Demonstrated proficiency with Epic, HIS systems, estimation tools, eligibility systems, Microsoft Office Suite, and general office equipment (Required proficiency) Licenses and Certifications Certified Healthcare Access Associate (CHAA) (Preferred) Physical Demands Standing Occasionally Walking Occasionally Sitting Constantly Lifting Rarely up to 20 lbs Carrying Rarely up to 20 lbs Pushing Rarely up to 20 lbs Pulling Rarely up to 20 lbs Climbing Rarely up to 20 lbs Balancing Rarely Stooping Rarely Kneeling Rarely Crouching Rarely Crawling Rarely Reaching Rarely Handling Occasionally Grasping Occasionally Feeling Rarely Talking Constantly Hearing Constantly Repetitive Motions Frequently Eye/Hand/Foot Coordination Frequently Travel Requirements 10%