Financial Counselor

Join to apply for the Financial Counselor role at Colorado Retina Associates
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Colorado Retina Associates is the premier retina practice of the Rocky Mountain region. Come join a team that strives to provide advanced care and cutting-edge therapies for our patients. We aim to take great care of our team members by providing competitive salary & benefits, continuing education and advancement programs, opportunity to work with the top-ranked retina specialists in the US and state-of-the-art equipment and retina treatment methods.

Colorado Retina Associates is complying with the Covid-19 Vaccine Mandate. Colorado Retina requires employees to be vaccinated as a condition of employment, subject to accommodation. All candidates, upon hire, will be required to provide proof of vaccination.

The Financial Counselor performs all necessary activities to ensure patient care can proceed as scheduled including verifying insurance coverage, confirming referral requirements, requesting referrals when needed, verifying payer coverage of proposed treatment plans, requesting and tracking prior authorizations, and appealing denied authorization requests. This role reviews patient accounts for accuracy and corrects as necessary, prepares Good Faith Estimates (GFEs), and collects payment in advance or provides direction to office staff to do so.

This position works directly with clinic personnel, insurance companies, funding organizations, and patients.

• Reviews patient appointment schedules in advance and confirms that appointments are scheduled correctly, that insurance coverage is active and accurate and is attached to the appointment.
• Utilizes eligibility systems, payer web portals, or phone calls to confirm active insurance coverage as needed.
• Confirms prior authorizations and referrals are in place; confirms diagnosis submitted supports medical necessity; requests referrals and authorizations as needed and documents in Next Gen; appeals denied prior authorization requests.
• Adds alerts and authorizations into Next Gen and Nextech.
• Submits benefits investigation (BI) requests to drug funding organizations to confirm benefits coverage status.
• Follows up on paperwork process through to final decisions for co-pay assistance programs.
• Reviews patient account balances for accuracy; corrects as necessary; explains balances to office staff and patients as needed.
• Provides cost and out-of-pocket expense estimates to patients as needed.
• Assists patients with payment arrangements and with financial applications.
• Maintains patient confidentiality at all times.
• Shows dependability and reliability in achieving goals.

• High School Diploma or GED.
• Associate or bachelor’s degree preferred or a combination of years and relative experience.
• Two or more years' experience working in a billing setting.
• Broad knowledge and experience in Insurance authorizations and funding programs.
• Above average skills in Insurance navigation and eligibility.
• Excellent communication skills and a positive attitude.
• Ability to make independent decisions and exercise discretion when working with patients and insurance companies.
• Excellent analytical and problem-solving skills.
• Strong verbal and written communication skills.
• Familiarity with medical terminology and abbreviations.