Patient Financial Counselor (Finance)

Patient Financial Counselor

The Patient Financial Counselor oversees patient payments, billing inquiries, and enrollment into assistance programs and payment plans. They collaborate with billing partners to submit claims promptly and ensure payments from assistance program vendors. Additionally, they provide expertise to clinic staff on billing inquiries related to assistance programs and self-pay encounters.

This is a Remote position; however, all candidates considered for this position must currently reside within Central California.

Duties / Responsibilities:

Prepares and submits clean claims to various insurance companies either electronically or by paper.
Contacts Insurance companies regarding unpaid claims via rebill, appeals, or phone.
Accepts in-coming phone calls for patient inquiries.
Answers questions from patients, clerical staff and insurance companies via phone, email, and messaging portals.
Identifies and resolves patient billing complaints.
Prepares, reviews and sends patient statements as needed.
Mails appropriate patient contact letters to resolve outstanding claims.
Evaluates patient's financial status and establishes budget payment plans.
Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
Utilizes Practice Management software and completes assigned AR and Patient tasking.
Participates in educational activities and attends monthly staff meetings.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Responding to all PAP inquiries via email inbox, phone calls to billing and PAP line, MS Teams messages, and via individual tasks in NextGen.
Maintaining NextGen Patient Assistance Program tasks and communicating with billing staff regarding enrollments, re-enrollments, etc.
Reviewing drug balance report and enrolling patients into Patient Assistant programs as applicable, based on outstanding balances.
Manage all first time and re-enrollment of patients into Patient Assistance Programs
Responsible for claims submissions to various PAPs (via online portal)
Responsible for payment posting from various PAPs
Submitting appeals as necessary
Training Front Desk and Billing staff on PX Connect and drug portals
Acts as gatekeeper for all PAP portal access:

New hires
Disabling access to PAP portals upon notification of termination/resignation
Password resets

Establishes and maintains professional relationships with various pharmaceutical vendors/reps, to stay current on medication and PAP happenings, protocol, and pertinent billing guidelines
Performs other duties as assigned.