Patient Financial Counselor & Collections Agent

About the Role

The Patient Financial Counselor and Collections Agent discusses insurance eligibility, benefits, and authorization requirements with patients; explains insurance coverage and associated out-of-pocket costs; and assists patients in understanding outstanding balances. Responsibilities include establishing payment plans when necessary, collecting initial payments, issuing payment reminders, and maintaining knowledge of a variety of insurance types, including government-sponsored plans.

The Patient Financial Counselor and Collections Agent discusses insurance eligibility, benefits, and authorization requirements with patients; explains insurance coverage and associated out-of-pocket costs; and assists patients in understanding outstanding balances. Responsibilities include establishing payment plans when necessary, collecting initial payments, issuing payment reminders, and maintaining knowledge of a variety of insurance types, including government-sponsored plans.

As the patient financial counselor and collections agent, you support patients by clearly and calmly explaining billing questions related to claims, payments, and balances, helping patients better understand their accounts and feel confident in the billing process. Your attention to detail and follow-up directly contribute to a better overall patient experience and a smoother revenue cycle operation. You determine collectability of patient accounts in partnership with the collection’s agent.

You ensure appropriate escalation of delinquent accounts to external collection agencies and support effective follow-through on accounts progressing toward legal action.

• Provide professional, patient-centered support by communicating clearly and effectively with patients, families, and other authorized representatives.
• Use active listening to understand patient concerns and respond appropriately.
• Demonstrate strong time management and organizational skills while managing multiple inquiries and priorities.
• Utilize strong problem-solving skills to evaluate patient account status and determine appropriate collection actions.
• Communicate with the Sr. Director, Rev Cycle regarding problem accounts, unusual payments, or necessary adjustments to ensure accurate resolution.

• Prepare and review daily patient account statements for accuracy and completeness.
• Review patient records to obtain treatment, insurance, and billing information and verify insurance benefits.
• Identify patients eligible for financial assistance and assist with required applications and documentation.
• Respond to patient and customer billing inquiries regarding claims, payments, and account balances with professionalism, empathy, and effective problem-solving skills.
• Counsel patients on billing responsibilities, payment options, discounts, and payment arrangements.
• Process in-person and telephone payments and establish payment plans for outstanding balances.
• Monitor account activity and payments to support timely resolution of patient accounts.
• Assist with bad debt processes, past-due accounts, self-pay balances, and collection activities.
• Communicate with patients regarding delinquent accounts and collections policies and coordinate with external collection agencies as needed.

• Support adherence to established hospital collection policies and procedures while ensuring patients understand their responsibility to provide accurate and timely information.
• Maintain strict confidentiality of patient health and financial information in accordance with HIPAA regulations and organizational policies.