Financial Counselor

Florida Orthopaedic Institute; Clearwater, Northern (FL, KY); Hybrid; USD 40,000 - 55,000; Full time

Job summary

Orthopaedic Solutions Management in Clearwater, FL is seeking a Financial Counselor to manage unpaid patient balances, verify insurance, establish payment plans, and resolve billing concerns with accuracy. You will handle high volumes of patient calls, analyze deductibles and coinsurance, and document cases to ensure timely follow-up.

The role requires 5+ years in medical billing, CPT/ICD-10 knowledge, and strong communication skills.

Qualifications

• High School Diploma or GED required.
• Minimum of 5 years of medical billing experience.
• Working knowledge of CPT and ICD-10 coding.
• Understanding of Explanation of Benefits (EOBs) and reimbursement practices.

Responsibilities

• Respond to a high volume of incoming patient calls related to self-pay statements, billing inquiries, and payment concerns.
• Initiate outbound collection calls to patients on an ongoing basis in a professional and customer-focused manner.
• Review and monitor assigned accounts and collection reports to ensure timely follow-up and resolution.
• Analyze self-pay balances to determine patient financial responsibility, including deductibles, coinsurance, and contractual discounts.
• Establish and monitor payment arrangements and provide timely follow-up on agreed payment plans.
• Process patient payments accurately and in accordance with company procedures.
• Research accounts deemed potentially non-collectible and prepare them for referral to collection agencies as appropriate.
• Identify billing issues requiring further review and communicate findings to appropriate billing staff.
• Handle billing loop calls and respond to inquiries from patients, physician offices, and insurance companies.
• Resolve patient billing problems while maintaining excellent customer service and preserving patient relationships.
• Address patient concerns in a calm, courteous, and professional manner; elevate to Quality Department as needed.
• Meet productivity metrics and KPIs; maintain HIPAA compliance.

Skills

Insurance guidelines

Customer service

Attention to detail

Verbal communication

Written communication

Independent work

Multitasking

Professional demeanor

Education

High School Diploma or GED

Job description

Morton Plant 301 | FOI Clearwater
430 Morton Plant
Suite 301
Clearwater, FL 33756, USA

Description

Job Summary

The Financial Counseloris responsible forthetimelyandaccuratefollow-up and resolution of unpaid patient balances. This position manages a high volume of patient interactions related to self-pay accounts, analyzes patient responsibility, obtains and verifies insurance information,establishespayment arrangements, and processes patient payments. The Financial Counselor serves as a billing representative, resolving patient financial concerns that mayimpacta patient’s ability to receive services.

Key Responsibilities

• Respond to a high volume of incoming patient calls related to self-pay statements, billing inquiries, and payment concerns.
• Initiate outboundcollectioncalls to patients on an ongoing basis in a professional and customer-focused manner.
• Review andmonitorassigned accounts and collection reports to ensuretimelyfollow-up and resolution.
• Analyze self-pay balances todeterminepatientfinancial responsibility, including deductibles, coinsurance, and contractual discounts.
• Establish andmonitorpayment arrangements and providetimelyfollow-up on agreed payment plans.
• Process patient payments accurately andin accordance withcompany procedures.
• Research accountsdeemedpotentially non-collectible andpreparethem for referral to collection agencies asappropriate.
• Ensure all available payment resources have been researched and exhausted prior to escalation.
• Identifybilling issues requiring further review (e.g., claim corrections, appeals) and communicate findings to appropriate billing staff through documented patient cases.
• Handlebilling loopcalls andrespondto inquiries from patients, physician offices, and insurance companies.
• Resolve patient billing problems whilemaintainingexcellent customer service and preserving patient relationships.
• Address patient concerns in a calm, courteous, and professional manner, including interactions with dissatisfied patients; elevate concerns to the Quality Department as needed.
• Meet established productivity metrics and key performance indicators (KPIs).
• Maintain compliance with HIPAA and all company plans, policies, and procedures set forth byOrthopaedicSolutionsManagemet.
• Perform reports, projects, and other duties as assigned.

Education and Experience

• High School Diploma or GEDrequired.
• Minimum of 5years ofprior medical billing experience or equivalent required.
• Working knowledge of CPT and ICD-10 codingrequired.
• Demonstrated understanding of Explanation of Benefits (EOBs) and reimbursement practices, including deductibles, coinsurance, and contractual adjustments.

Preferred qualifications & skills

• Strong knowledge of insurance guidelines and payer requirements.
• Excellent customer service skills with the ability to handle sensitive financial conversations.
• Strong attention to detail witha high levelof accuracy.
• Effective verbal and written communication skills.
• Ability to work independently with minimal supervision while meeting goals, deadlines, and performance metrics.
• Ability to manage multiple tasks in a deadline-driven environment.
• Professional, well-presented, and tactful demeanor.
• Ability to work collaboratively as part of a team and meet the expectations of internal and external customers.

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.