Patient Financial Counselor & Access Advocate

University Hospitals; Shaker Heights (OH); On-site; USD 42,000 - 64,000; Full time

Job summary

University Hospitals in Shaker Heights, OH is seeking a Financial Counselor to help patients understand and manage the cost of care. You will explain insurance benefits, estimates, and payment options, aiming to reduce financial barriers before and after services.

You will collaborate with providers, community partners, and internal teams to support financial clearance, reimbursement, and a positive patient experience while complying with regulatory requirements.

Responsibilities

• Provide compassionate, timely financial counseling and support to patients before scheduled services.
• Prepare and explain patient estimates and Good Faith Estimates (GFEs).
• Help patients understand deductibles, copayments, coinsurance, out-of-pocket costs, and other financial responsibilities.
• Review insurance benefits and explain coverage limitations that may affect a patient's costs.
• Guide patients through out-of-network benefits, reference-based plans, self-pay options, and other financial considerations.
• Conduct financial counseling appointments for IVF and other specialty services.
• Help patients establish payment arrangements, explore financing options, and make initial payments when appropriate.
• Conduct pre-service financial clearance and collection activities.
• Proactively reach out to patients who may need additional financial support before receiving care.
• Identify financial or reimbursement concerns early and connect patients with appropriate solutions or additional review.
• Help patients understand and apply for available hospital financial assistance programs.
• Guide patients through application and documentation requirements.
• Assess financial hardship and identify programs and resources that may help.
• Assist patients with Medicaid applications, renewals, redeterminations, and eligibility verification.
• Support presumptive eligibility screenings and enrollment.
• Follow pending Medicaid applications through eligibility determination.
• Serve as an Authorized Representative for patients when properly designated.
• Partner with county agencies, managed care organizations, government agencies, and community resources to help patients access coverage.
• Educate uninsured and underinsured patients about Medicaid, insurance, financial assistance, and other available resources.
• Listen to patient concerns, research account questions, and provide clear solutions and next steps.
• Manage inbound and outbound financial counseling calls.
• Answer questions about estimates, Good Faith Estimates, insurance coverage, Medicaid, payment plans, financial assistance, billing concerns, and financial clearance.
• Provide proactive support to patients who may be financially at risk.
• Connect patients with Customer Service or other departments when additional assistance is needed while helping ensure a smooth handoff.
• Escalate sensitive or complex concerns to the appropriate team.
• Create a positive patient experience through education, communication, empathy, and financial advocacy.
• Participate in community outreach events, health fairs, enrollment programs, and educational activities.
• Support efforts designed to expand healthcare access and connect uninsured patients with available resources.
• Review reports, worklists, and account information to identify opportunities to improve processes and the patient experience.Contribute ideas for improving workflows, technology, financial counseling practices, and patient engagement.
• Support department projects, reporting, analytics, and performance initiatives.
• Participate in initiatives involving financial counseling, Revenue Cycle performance, patient engagement, enrollment, and health equity.
• Assist with training, mentoring, and onboarding as assigned.
• Stay current on industry practices and share opportunities for improvement with leadership.

Job description

University Hospitals in Shaker Heights, OH is seeking a Financial Counselor to help patients understand and manage the cost of care. You will explain insurance benefits, estimates, and payment options, aiming to reduce financial barriers before and after services.

You will collaborate with providers, community partners, and internal teams to support financial clearance, reimbursement, and a positive patient experience while complying with regulatory requirements.