Patient Access Rep – Financial Counselor - TMCH Cancer Center

SUMMARY:

The Patient Access Rep - Financial Counselor is responsible for assisting patients and their families in understanding and managing the financial aspects of their healthcare. This includes verifying insurance coverage, estimating out-of-pocket costs, arranging payment plans, and identifying financial assistance programs. The role ensures compliance with hospital policies and regulatory requirements while delivering compassionate and informed support to patients.

ESSENTIAL FUNCTIONS:

·        Interview patients or their representatives to assess financial status and determine payment options.

·        Verify insurance eligibility, benefits, and authorization requirements.

·        Provide cost estimates and explain patient financial responsibility.

·        Collect deposits, co-pays, and deductibles; establish and monitor payment plans.

·        Assist patients in applying for financial assistance, charity care, or third-party funding.

·        Ensure completion of financial documentation in accordance with hospital policies.

·        Perform medical necessity screening and ensure compliance with system requirements.

·        Collaborate with clinical departments and physician offices to obtain necessary documentation.

·        Maintain accurate records and documentation in EHR and financial systems.

·        Prepare daily deposits and reconcile financial transactions.

·        Adhere to HIPAA and organizational confidentiality standards.

·        Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION: High school diploma or GED required; associate degree or vocational training in healthcare or finance preferred..

EXPERIENCE:Three (3) years in a healthcare or medical office setting, including experience in insurance verification, financial counseling, or patient access.

LICENSURE OR CERTIFICATION:None required; CHAA or related certification preferred.

KNOWLEDGE, SKILLS, AND ABILITIES:

·        Knowledge of healthcare billing, insurance plans, and financial assistance programs.

·        Strong interpersonal and communication skills.

·        Ability to explain complex financial information in a clear and compassionate manner.

·        Proficiency in EHR systems, payer portals, and Microsoft Office.

·        Attention to detail and accuracy in documentation.

·        Ability to manage multiple tasks in a fast-paced environment.