[Hiring] Financial Counseling Representative @Sanford Health

Role Description

The Financial Counseling Representative provides financial counseling to assist patients in understanding their financial responsibility to Sanford and to offer appropriate resources and options to meet that responsibility.

• Answers billing questions.
• Reviews patient's insurance coverage and Explanation of Benefits (EOBs).
• Provides clarification regarding what charges were incurred and why.
• Reviews insurance denials and explains the denial to the patient.
• Reviews payment plan guidelines and assists in setting up payment arrangements.
• Determines patient eligibility for payment assistance programs and assists in the application process.
• Educates patients on insurance concepts, including:
• Copayments
• Covered services
• Effective dates of coverage
• Referral requirements
• Obtaining valid referrals and resubmitting claims
• Influence of effective dates on insurance payments
• Assists patients with medical assistance program paperwork and referrals to Medicaid or other insurance aid or disability programs.
• Advises uninsured patients on outstanding medical costs and establishes payment plans.
• Interacts with patients in-person, empathizing and diffusing strong emotions.
• Calculates and provides cost estimates for medical procedures, including anticipated patient share.
• Advises on and collects prepayments for services not covered by insurance.
• May perform guest service duties as needed.
• Other duties as assigned.

Qualifications

• High school diploma or equivalent preferred.
• Post-secondary education preferred.
• Two years' experience in healthcare service or health insurance preferred.

Requirements

• Computer skills sufficient to operate online systems and complex software with advanced functionality.
• Oral and written communication skills sufficient to interpret and apply policies and procedures for clarification and problem resolution.
• Knowledge of third-party payers and basic bookkeeping or accounting principles.
• Thorough understanding of insurance products and ability to accurately read an EOB to determine adjustments, payments received, and calculate pending balances.

Company Description

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland.