Patient Financial Counselor

Ridgeview Medical Center; Waconia (MN); Hybrid; USD 50,000 - 70,000; Full time

Job summary

Ridgeview Medical Center in Minnesota is expanding its Patient Financial Services team to hire a full-time Patient Financial Counselor in a hybrid role. You will guide patients through insurance benefits, estimate anticipated liabilities, and help them access financial assistance and government programs.

Responsibilities include collecting payments, setting up payment plans, and coordinating with clinical departments to clarify coverage and options.

Qualifications

• High school diploma or equivalent.
• Experience in patient financial services or healthcare.
• Proven customer service experience.
• Knowledge of medical terminology.
• Experience with cost estimation in a medical setting.

Responsibilities

• Serve as the primary contact for patient financial assistance questions.
• Explain insurance benefits and help estimate patient liability.
• Assist with eligibility for government programs and financial assistance.
• Process payments and set up payment arrangements.
• Collaborate with clinical departments and Patient Financial Services.

Skills

Customer service

Medical terminology

Cost estimation

English communication

Multitasking

Attention to detail

Autonomy

Teamwork

Critical thinking

Education

High school diploma or equivalent

Post-secondary education in healthcare

Tools

EPIC

Microsoft Office

Job description

This is a hybrid role.

Purpose of Job

This is a newly expanded role at Ridgeview and the ideal candidate should have experience and expertise in working with patients as they navigate the financial responsibilities of their visit. The Patient Financial Counselor is responsible for providing patients with a positive financial experience by helping navigate insurance benefits and understand potential financial liability. This role is the patient's point of contact for financial assistance questions. The Financial Counselor collects payments, sets up payment arrangements, creates estimates, advises patients on their insurance benefits and coverage. This role will assist patients with eligibility for government programs, Ridgeview's financial assistance program, and other options for managing high medical liabilities.

Job Functions

1. Serve as the point of contact for all patient financial assistance related questions.
2. Communicate with patients to identify and understand financial, social, and medical histories and other relevant patient information.
3. Act as liaison between clinical departments, Patient Financial Services, and third parties to advocate for the patient and Ridgeview.
4. Gather all relevant information required to process financial assistance requests.
5. Assess the current financial situation of patients through the verification of patient insurance benefits; serving as the technical expert in confirming patients benefit coverage and hospital reimbursement:
   • Determine the patient's financial ability to pay and explain insurance coverage and benefits to the patient.
   • Initiate the financial screening process as appropriate to evaluate eligibility for assistance programs. Assist the patient in completing financial applications and gathering supporting financial documentation.
6. Determine eligibility for care at Ridgeview by assessing patient eligibility for Medical Assistance, Community Programs, and Government Programs:
   • Assess and offer payment alternatives which may include prepayment for elective care and applying for Ridgeview's financial assistance program
   • Identify eligible financial programming options and assist in completing all necessary documentation for specific federal, state, or Ridgeview financial assistance programs.
   • With provider involvement, determine urgency of scheduled care for patients with large financial liabilities resulting in either a decision to proceed or a decision to reschedule
7. Explain Ridgeview's payment policy to patients. Calculate and explain any patient liability before or at the time of service.
8. Counsel patients on out-of-pocket liabilities. Collect deductibles, pre-payments, and outstanding balances following established collection procedures; or alternatively, create a payment plan with the patient and document the agreement appropriately.
   • If unable to establish acceptable payment arrangements for elective procedures, inform provider and patient that services will be rescheduled or cancelled.
9. Communicate financial coverage status and applicable financial decisions with all appropriate parties: patient, family, referring providers, and Ridgeview providers.
10. Perform other duties as assigned.

Minimum Education/Work Experience

• High school graduate or equivalent
• Previous customer-focused healthcare experience
• Proven customer service experience
• Knowledge of medical terminology
• Patient financial and/or cost estimation experience

Knowledge/Skills/Abilities

• Ability to effectively navigate a high-stress and fast-paced environment.
• Ability to meet and maintain the necessary background checks as aligned with position functions.
• Ability to communicate in the English language for effective written and verbal correspondence to complete listed job functions.
• Ability to multitask and maintain high attention to detail.
• Ability to perform basic math functions and count money.
• Ability to interact and service patients in a friendly and efficient manner.
• Knowledge of basic computer functions and Microsoft Office applications.
• Ability to work autonomously and as a team.
• Ability to respond appropriately to unpredictable and high stress situations and diverse patient populations.
• Capable of making independent decisions with the use of strong critical thinking and problem-solving skills.
• Ability to meet crucial timelines and productivity expectations.

Preferred Qualifications

• Previous experience in a patient financial services role
• Knowledge of health insurance, medical assistance, and other payment methods
• Post-secondary education in healthcare
• Bilingual
• Experience with EPIC

Physical Demands

Link to Physical Demands

Compensation

Many factors are taken into consideration when determining compensation such as: the requirements of the position, experience, education, knowledge, and skills along with location and internal equity. Pay listed does not include any shift, weekend, or other differentials.

Benefits

Ridgeview strives to provide comprehensive and market competitive benefits to meet the needs of our employees and their families.