Patient Financial Counselor

Winnebago Comprehensive Healthcare System; Northern (KY); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Winnebago Comprehensive Healthcare System is seeking a Patient Financial Counselor to assist uninsured and underinsured patients in identifying and securing health coverage, including Medicaid, ACA marketplace plans, and state programs. You will guide patients through applications, maintain confidential records, and advocate with insurers to resolve eligibility issues.

You will work in clinical and community settings, collaborating with partners to connect patients with resources and ensure

Qualifications

• High School Diploma or equivalent.
• ACA Navigator or Medicaid enrollment experience preferred.
• Experience with Medicaid enrollment processes and ACA enrollment.
• Familiarity with insurance policies, billing, and reimbursement systems.

Responsibilities

• Meet with uninsured patients to assess financial and insurance status.
• Counsel patients on Medicaid, ACA marketplace plans, and subsidies.
• Assist with completing and submitting applications for coverage.
• Maintain confidential records and follow up on application status.
• Advocate with insurers or government entities to resolve eligibility issues.
• Travel to clinics, community sites, and enrollment events as needed.

Skills

Policy interpretation

Communication

Documentation

Confidentiality

Teamwork

Independent work

Education

High School Diploma

Tools

EMR software

Microsoft Office

Enrollment portals

Job description

Job Purpose & Position Overview

The Patient Financial Counselor is dedicated to assisting uninsured and underinsured patients in identifying, applying for, and securing appropriate health coverage. This role is vital in connecting patients to resources such as Medicaid, Affordable Care Act (ACA) marketplace plans, and state-specific programs. Additionally, this role will serve as the subject matter expert for interpreting rules and regulations for alternate resources to patients.

Specific Job Duties/Responsibilities:

• Proactively meet with uninsured patients to assess their financial and insurance status.
• Serve as a trusted resource for uninsured patients by providing personalized counseling on health coverage options, including:
• Medicaid and Medicaid expansion programs
• ACA marketplace plans and subsidies
• Local, state, or nonprofit assistance resources
• Help patients complete and submit applications for medical coverage, ensuring they understand eligibility criteria and required documentation.
• Work one-on-one with patients and families in both clinical and community settings—including clinics, hospitals, outreach events, and partner organizations.
• Build strong relationships with community partners, nonprofits, and local agencies to refer patients to additional support services when needed.
• Participate in outreach initiatives, health fairs, and enrollment events to connect with underserved populations and raise awareness of available support.
• Maintain accurate and confidential records of patient interactions, follow-up needs, and application progress.
• Follow up with patients regularly to monitor application status and provide additional support as needed.
• Stay informed of federal, state, and local healthcare policy updates, especially those affecting Medicaid, the ACA, and underserved communities.
• Advocate on behalf of patients when needed with government or insurance entities to help resolve eligibility or approval issues.
• Other Job Duties: In addition to office meetings, you may travel to patients’ home when necessary to complete applications or complete online account setup, travel to community sites, enrollment events, or partner agencies as necessary.
• Flexibility in scheduling may be required to meet patient availability, including some evenings/weekends.

Required Qualifications/Skills:

• High School Graduate or equivalent; Preferred 3 years of ACA Navigator, AC Enrollment Specialist, or Medicaid Enrollment Specialist experience for American Indians.
• Experience with Medicaid enrollment processes and Affordable Care Act enrollment for American Indians
• Familiarity with insurance policies, billing processes, and reimbursement systems.
• Proficiency in documenting using electronic medical records and practice management system
• Strong verbal and written communication skills to interact with medical professionals, insurance companies, and internal teams.
• Skill in a variety of software systems; including electronic medical record software, Microsoft applications, and third-party application portals.
• Exceptional attention to detail and ability to work under deadlines while maintaining high ethical standards.
• Ability to maintain confidentiality and follow strict regulatory guidelines.
• Ability to work independently and collaboratively as part of a team with multiple priorities and deadlines

Physical Requirements:

• Normal to light office work which includes the ability to lift 30 lbs.
• Regularly required to walk, stand, and sit for extended periods of time and use hands to operate computer keyboard, phone, and various office equipment.

Cognitive Requirements:

• Reading, writing, calculating
• Excellent social interaction skills
• Reasoning/Analysis
• Ability to work effectively both independently and as a team
• Works with minimal supervision

Language Requirements:

• Must possess the ability to read, write, and speak the English language fluently.
• Must be able to continually and effectively employ professional verbal and written communications skills.

Certificates, Licenses & Registrations:

• All applicants will comply with 45 CFR 1301, Subpart D, Section 1301.31, C and D, which require all prospective employees to sign a declaration prior to employment regarding all arrests and convictions of child abuse or violent felonies and to comply with PL 101-630 and PL 101-637 regarding criminal records check.