Surgical Financial Navigator

Peachtree Orthopedics; Atlanta (GA); On-site; USD 55,000 - 75,000; Full time

Job summary

Peachtree Orthopedics in Atlanta, GA seeks a Surgical Financial Counselor to support financial clearance and patient financial services in the Revenue Cycle department. The role handles insurance verification, cost estimation, and financial counseling for procedures in ambulatory surgery centers and hospital settings.

The Counselor partners with patients, providers, payers, and internal teams to ensure accurate financial information, regulatory compliance, and an exceptional patient experience.

Qualifications

• Associate degree in Finance, Accounting, Healthcare Administration, Business, or related field preferred; equivalent healthcare revenue cycle experience required.
• Minimum 2 years of healthcare financial counseling, patient account management, insurance verification, or revenue cycle experience.
• Knowledge of ICD-10, CPT, HCPCS coding, CMS 1500/UB04 claim forms, Medicare, managed care, and commercial insurance plans preferred.
• Experience with Athena, Microsoft Excel, Word, PowerPoint, and healthcare billing systems preferred.
• Strong understanding of insurance benefits, patient financial responsibility calculations, reimbursement methodologies, and revenue cycle operations.
• Demonstrated analytical, communication, customer service, organizational, and problem-solving skills.

Responsibilities

• Review scheduled surgical cases and generate financial clearance reports to identify patients requiring benefit verification, cost estimation, and financial counseling.
• Verify insurance eligibility, benefits, deductibles, co-payments, co-insurance amounts, out-of-pocket obligations, and authorization requirements for surgical procedures.
• Analyze payer benefits and coverage details to determine patient financial responsibility for professional and facility services.
• Prepare and communicate detailed cost estimates to patients and guarantors prior to scheduled surgical procedures.
• Educate patients regarding insurance benefits, financial obligations, payment options, and available financial assistance programs.
• Establish deposit requirements, collect pre-service payments, and coordinate payment arrangements in accordance with organizational policies.
• Review and process financial assistance applications while maintaining accurate documentation and reporting of eligibility determinations.
• Maintain accurate account documentation, financial calculations, benefit verification details, and patient communications within Athena and related systems.
• Prepare daily, weekly, and monthly operational reports related to surgical financial clearance activities, collections, and reimbursement support.
• Serve as a subject matter expert for patient financial counseling processes, insurance benefits, and revenue cycle workflows related to surgical services.
• Collaborate with Scheduling, Clinical, ASC Operations, Billing, Front Desk, and Revenue Cycle teams to resolve financial concerns and improve workflow efficiency.
• Support onboarding and training activities for new team members as assigned.
• Ensure compliance with HIPAA, CMS guidelines, payer regulations, and organizational financial policies and procedures.
• Participate in departmental meetings, audits, compliance activities, and process improvement initiatives as assigned.
• Other duties as assigned.

Skills

Analytical skills

Communication skills

Customer service

Organizational skills

Problem-solving

Education

Associate degree or equivalent

Tools

Athena

Microsoft Excel

Word

PowerPoint

Healthcare billing systems

Job description

Peachtree Orthopedics in Atlanta, GA seeks a Surgical Financial Counselor to support financial clearance and patient financial services in the Revenue Cycle department. The role handles insurance verification, cost estimation, and financial counseling for procedures in ambulatory surgery centers and hospital settings.

The Counselor partners with patients, providers, payers, and internal teams to ensure accurate financial information, regulatory compliance, and an exceptional patient experience.