What are the responsibilities and job description for the Patient Financial Counselor position at Valley Ob-Gyn Clinic?
Position Summary
The Patient Financial Counselor at Valley Ob-Gyn Clinic is a vital link between our clinical care team and the patient's financial peace of mind. This role focuses on providing compassionate, proactive guidance to patients facing significant medical expenses, such as those related to pregnancy or elective surgery. You will be responsible for helping patients navigate complex insurance benefits, providing accurate cost estimates, and establishing sustainable payment plans to ensure they can focus on their health rather than their bills.
Essential Duties and Responsibilities
- Insurance Guidance: Verify patient insurance eligibility and explain specific benefits, including deductible status, co-insurance, and out-of-pocket maximums.
- Cost Estimates: Generate and present detailed financial estimates for upcoming major procedures or global pregnancy care.
- Payment Plan Coordination: Establish and monitor formal payment arrangements for patients who must meet high deductibles before or during their care cycle.
- Pre-Authorization Support: Work closely with the clinical and billing teams to ensure all necessary pre-authorizations are secured prior to treatment.
- Patient Advocacy: Serve as a compassionate point of contact for patient inquiries regarding billing statements and insurance denials.
- Financial Assistance: Identify and assist eligible patients in applying for state programs or clinic-specific financial aid when applicable.
Preferred Qualifications
- Experience: Minimum of 2–3 years in medical billing, insurance verification, or healthcare financial counseling, preferably in a women's health or surgical setting.
- Communication: Exceptional interpersonal skills with the ability to discuss sensitive financial matters with empathy and professionalism.
- Technical Skills: Proficiency in electronic medical records (EMR) systems—knowledge of Athena Health is a plus as it is used by Valley Ob-Gyn Clinic.
- Knowledge: Deep understanding of Michigan-specific insurance payers and general healthcare revenue cycle processes.