Financial Counselor - Outpatient

Grady Memorial Hospital Corporation; Atlanta (GA); On-site; USD 52,000 - 61,000; Full time

Job summary

Grady Memorial Hospital Corporation is seeking a Financial Counselor to conduct comprehensive patient interviews and determine eligibility for financial assistance and third party payer programs. The role requires verification of third party coverage, obtaining authorizations, and accurately entering patient data into Epic while ensuring compliance with grants and regulatory standards.

Key duties include coordinating benefits for admissions, assisting patients with applications for Medicaid and

Qualifications

• Interacts with patients, family members, employees, visitors and clinicians regarding financial clearance.
• Determines eligibility for third party payer and assistance programs.
• Obtains necessary authorizations and precertifications.
• Enters patient demographics and insurance information into Epic.

Responsibilities

• Conducts comprehensive patient interviews to determine eligibility for financial assistance or third party payer coverage.
• Verifies third party coverage and coordinates benefits for admissions and procedures.
• Obtains required signatures and explains documents to patients to ensure compliance and understanding.

Job description

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

The Financial Counselor's essential duties consist of conducting comprehensive patient interviews while adhering to the Financial Assistance Program standards. Verifies the potential of third party coverage, determine if patients meet criteria for third party assistance programs and completes applications as appropriate. Complies with third party payer standards related to obtaining authorizations/ precertifications. Accurately enters patient information into the enterprise hospital information system, i.e., Epic. Complies with regulatory compliance standards by explaining various documents and obtaining signatures. The Financial Counselor's essential duties consist of conducting comprehensive patient interviews while adhering to the Financial Assistance Program standards. Verifies the potential of third party coverage, determine if patients meet criteria for third party assistance programs and completes applications as appropriate. Complies with third party payer standards related to obtaining authorizations/ precertifications. Accurately enters patient information into the enterprise hospital information system, i.e., Epic. Complies with regulatory compliance standards by explaining various documents and obtaining signatures.

QUALIFICATIONS

• 35% - Interacts with patients, family members, employees, visitors and clinicians regarding financial clearance. Provides assistance to patients via the call center, online, and in-person regarding third party payer and eligibility requests. Conducts accurate interviews with patients or patients’ representatives to determine eligibility for assistance. During the interviewing process, determine if patients meet criteria for any assistance programs and/or Grady’s Financial Assistance Program. Verifies third party payer information or the possibility of third party payer coverage via electronic verification tools or telephone. Notifies payer of patient’s hospital admission. Obtains prior authorization for scheduled procedures, Ambulatory Surgeries and Surgery Admits. Accurately performs registrations and Epic updates with patient demographic, insurance information and authorization accurately. Communicates effectively and provides written documentation to patients regarding discounts and patient financial responsibility. Analyzes and resolves patient billing inquiries and make adjustments to ensure proper collections of the patient’s financial responsibility related to eligibility for financial assistance or third party payer coverage.
• 20% - Determine if patient meets criteria for other assistance programs and complete applications for assistance as appropriate. Completes program applications, e.g., Medicaid, Cancer State Aid, Georgia Crime Victims Compensation Program, etc., application(s) for eligible patients. Secures newborns Medicaid Recipient’s Numbers via GAMMIS. Submits applications to the appropriate organization for review, approval and/or denial in a timely manner. Updates Epic accurately and timely with converted applications and/or status notes.
• 40% - Ensures financial clearance by verifying third party payer information, coordinating benefits, initiating third party payer notification for emergency admissions/observations, and/or obtain third party payer authorizations. Conducts bedside interviews and pre-admission/ambulatory surgery patient interviews to ensure all regulatory compliance documents are explained and patient/patient representative signature is obtained. Verifies third party payer information and/or the possibility of third party coverage. Updates Epic with insurance information and coordinate benefits when appropriate. Initiates third party payer notification for emergency admissions/observations within payer’s specified timeframe and updates Epic with status and notes. Coordinates financial clearance for pre-admissions by securing authorization, scheduling pre admission appointments, if applicable, and collecting co-payments/deposits prior to service and post discharge. Escorts patients and/or patients’ families to various service areas for elective services.
• 5% - Other duties as assigned.

Core Competencies

• 1. Patient-Centered Care - Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.
• 2. Integrity - Accountability - Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.
• 3. Collaboration - Teamwork - Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.
• 4. Communication - Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.
• 5. Respect - Inclusion - Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.
• 6. Quality - Safety - Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.
• 7. Adaptability - Resilience - Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.
• 8. Continuous Improvement - Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.
• 9. Leadership - Professionalism - Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.
• 10. Employee Experience Focus - Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.

Grady Total Rewards

Grady Total Rewards At Grady, we believe in supporting the health, well-being, and growth of every team member. Our Total Rewards package is designed to provide competitive pay and comprehensive benefits that make a difference in your life and career, including:

• Health - Wellness: Medical, dental, vision, and prescription drug coverage.
• Financial Security: Retirement savings plans with employer contributions, life insurance, and disability coverage.
• Work-Life Balance: Paid time off, holidays, and family leave benefits.
• Career Growth: Tuition reimbursement, professional development programs, and opportunities for advancement.
• Employee Support: Employee Assistance Program (EAP), wellness initiatives, and discounts on services.

Why Join Grady?

Grady Health System is more than a hospital - we are a vital part of Atlanta and the surrounding communities. For over 125 years, Grady has been committed to providing exceptional care, advancing health equity, and making a difference in the lives of those we serve. When you join Grady, you become part of a team that values excellence, compassion, innovation, and collaboration. Here, every role matters. Whether you provide direct patient care, support our operations, or lead teams, you play an important part in fulfilling our mission. We offer opportunities to learn, grow, and build a meaningful career in an environment where your contributions are recognized and valued. At Grady, we don’t just work, we make an impact.

Equal Opportunity Employer Statement

Grady Health System is proud to be an equal opportunity employer. We are committed to fostering a workforce where all employees feel valued, respected, and empowered to succeed. We prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic. Grady is dedicated to creating an accessible work environment and provides reasonable accommodations to qualified individuals with disabilities to ensure equitable opportunities for success.

Join our Talent Community

At Grady Health System, we are more than just a healthcare provider – we are a lifeline for our community. With a rich history of compassionate care, we’ve been serving Atlanta and beyond for over 125 years. As one of the nation’s leading public health systems, we are committed to delivering exceptional, patient-centered care to all, regardless of ability to pay. Our dedicated team of healthcare professionals brings a passion for making a difference, and together, we provide top-notch services in every specialty, from trauma care to maternal health, to community-based programs that improve lives. We embrace innovation, diversity, and collaboration to meet the unique needs of our patients and create a healthier future for everyone. Join us in our mission to make a lasting impact - because at Grady, your care, your career, and your community matter.