Patient Financial Counselor & Collections Agent

Description

About the Role

The Patient Financial Counselor and Collections Agent discusses insurance eligibility, benefits, and authorization requirements with patients; explains insurance coverage and associated out-of-pocket costs; and assists patients in understanding outstanding balances. Responsibilities include establishing payment plans when necessary, collecting initial payments, issuing payment reminders, and maintaining knowledge of a variety of insurance types, including government-sponsored plans.

How You’ll Make an Impact

As the patient financial counselor and collections agent, you support patients by clearly and calmly explaining billing questions related to claims, payments, and balances, helping patients better understand their accounts and feel confident in the billing process. Your attention to detail and follow-up directly contribute to a better overall patient experience and a smoother revenue cycle operation. You determine collectability of patient accounts in partnership with the collection’s agent. You ensure appropriate escalation of delinquent accounts to external collection agencies and support effective follow-through on accounts progressing toward legal action.

Customer Service & Communication

• Provide professional, patient-centered support by communicating clearly and effectively with patients, families, and other authorized representatives.
• Use active listening to understand patient concerns and respond appropriately.
• Demonstrate strong time management and organizational skills while managing multiple inquiries and priorities.
• Utilize strong problem-solving skills to evaluate patient account status and determine appropriate collection actions.
• Communicate with the Sr. Director, Rev Cycle regarding problem accounts, unusual payments, or necessary adjustments to ensure accurate resolution.

Patient Accounts & Accounts Receivable Support

• Prepare and review daily patient account statements for accuracy and completeness.
• Review patient records to obtain treatment, insurance, and billing information and verify insurance benefits.
• Identify patients eligible for financial assistance and assist with required applications and documentation.
• Respond to patient and customer billing inquiries regarding claims, payments, and account balances with professionalism, empathy, and effective problem-solving skills.
• Counsel patients on billing responsibilities, payment options, discounts, and payment arrangements.
• Process in-person and telephone payments and establish payment plans for outstanding balances.
• Monitor account activity and payments to support timely resolution of patient accounts.
• Assist with bad debt processes, past-due accounts, self-pay balances, and collection activities.
• Communicate with patients regarding delinquent accounts and collections policies and coordinate with external collection agencies as needed.

Policies, Compliance, & Collection Processes

• Support adherence to established hospital collection policies and procedures while ensuring patients understand their responsibility to provide accurate and timely information.
• Maintain strict confidentiality of patient health and financial information in accordance with HIPAA regulations and organizational policies.

Operational & Administrative Support

• Support organizational and operational needs through accurate documentation, data management, reporting, and effective use of technology systems.
• Maintain accurate patient, collections, and financial data to support decision-making, operational efficiency, and regulatory requirements.
• Additional duties and responsibilities assigned based on organizational needs.

Requirements

Qualifications

• High school diploma or equivalent.
• Prior billing experience with working knowledge of computer systems, medical terminology, and effective communication skills preferred.

Who You Are

• Detail-oriented with a strong focus on accuracy, organization, and follow-through.
• Driven and self-motivated, demonstrating initiative and ownership in daily responsibilities.
• Ethical and professional in all interactions, maintaining integrity and confidentiality.
• Patient, empathetic, and respectful when working with patients, families, and associates.
• Strong communicator with the ability to explain patient accounts information clearly and effectively.
• Organized and able to manage multiple priorities in a fast-paced environment.
• Problem-solver who takes initiative to research, address, and resolve patient account issues.
• Calm under pressure and able to maintain composure in challenging or high-volume situations.
• Team-oriented while also capable of working independently with minimal supervision.

Skills & Capabilities

• Excellent written and verbal communication skills, with the ability to interact professionally with patients, insurance representatives, and internal associates.
• Strong attention to detail to ensure accuracy in claims processing, billing records, and patient account reconciliation.
• Highly organized with the ability to manage multiple tasks and priorities effectively in a fast-paced environment.
• Skilled in multitasking while maintaining accuracy, efficiency, and timely follow-up on patient accounts.
• Ability to prioritize work independently while meeting deadlines and maintaining compliance with collections procedures.
• Strong problem-solving skills to identify, research, and resolve collections related issues promptly.

Position Details

Schedule: Full-time, non-exempt, with the expectation to work 36-40 hours per week. Regular and punctual attendance is required.

Physical Requirements: Ability to converse regularly with patients by phone or in person, continually sitting and typing at a computer terminal, some ambulation, bending, and lifting up to 25 pounds.

Equipment: Standard office equipment; computer, copier, fax machine, calculator.

Acknowledgment

I acknowledge that I have reviewed and understand the contents of this job description. I understand that this document may be revised at the organization’s discretion and does not constitute a contract of employment. Employment is at will and may be changed with or without notice, including but not limited to duties, location, compensation, benefits, or employment status.