Financial Counseling Representative

sanford; Marshfield (WI); On-site; USD 24,000 - 39,000; Full time

Job summary

Sanford Health is seeking a Financial Counseling Representative to assist patients in understanding their financial responsibility and available resources. The role involves counseling on billing, insurance coverage, and payment options in a compassionate, patient-centered manner.

You will review EOBs, explain charges, and guide patients through payment plans, potential assistance programs, and eligibility for Medicaid or other aid.

Qualifications

• High school diploma (or equivalent) preferred.
• Post-secondary education preferred.
• Two years' experience in healthcare service or health insurance preferred.

Responsibilities

• Answers billing questions.
• Reviews insurance coverage and EOBs.
• Explains charges incurred and why.
• Reviews insurance denials and explains denial.
• Assists in setting up payment arrangements.
• Assists for payment assistance programs and applications.
• Educates patients on copays, coverage, referrals timing and insurance concepts.
• Helps with Medicaid or other aid applications.
• Advises uninsured patients on costs and payment plans.
• Interacts with patients in person with empathy.
• Calculates estimated patient share for procedures.
• Advises on prepayments for services not covered.
• May assist with guest services.
• Other duties as assigned.

Skills

Empathy

Communication

Patient education

Billing knowledge

Education

High school diploma or equivalent

Post-secondary education

Tools

Billing software

EHR systems

Online systems

Job description

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America's heartland.

Work Shift: 8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours: 40

Compensation: Salary Range: $17.50 - $28.00

Union Position: No

Summary

The Financial Counseling Representative provides financial counseling to assist patients in understanding their financial responsibility to Sanford and to offer appropriate resources and options to meet that responsibility.

Job Description

• Answers billing questions.
• Reviews patient's insurance coverage and Explanation of Benefits (EOBs).
• Provides clarification regarding what charges were incurred and why they were incurred.
• Reviews insurance denials and provides an explanation for the denial to the patient.
• Reviews payment plan guidelines and assists in setting up payment arrangements.
• Determines if patient is eligible for payment assistance programs and assists in the application process, if applicable.
• Educates patients regarding insurance concepts, such as what copayments are, what services are covered, effective dates of coverage, when a referral is needed and the effect on insurance, how to obtain a valid referral and resubmit the claim, and how effective dates of coverage influence insurance payments.
• May assist patient in filling out medical assistance program paperwork, as well as referrals to Medicaid or other insurance aid or disability programs.
• Frequently advises uninsured patients on outstanding medical costs associated with procedures performed in a clinic setting and establishes a payment plan.
• Interacts with patients in-person and must be able to empathize with them while also diffusing strong emotions.
• Calculates and provides cost estimates for medical procedures, including the patient's anticipated share.
• Advises on and collects prepayments for services not covered by insurance.
• May perform guest service duties, as needed.
• Other duties as assigned.

Computer skills sufficient to operate on-line systems and complex software with advanced functionality.

Oral and written communication skills sufficient to interpret and apply policies and procedures for clarification and problem resolution.

Knowledge of third party payers and basic bookkeeping or accounting principles is required.

Requires a thorough understanding of insurance products and the ability to accurately read an EOB to determine what adjustments have been made, what payments have been received, and calculate pending balances.

Qualifications

• High school diploma or equivalent preferred. Post-secondary education preferred.
• Two years' experience in healthcare service or health insurance preferred.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to [e-mail].