Financial Compliance Counselor

Job Overview

The Financial Compliance Counselor is responsible for providing patients with a positive financial experience by helping patients navigate & understand insurance benefits and out-of-pocket responsibility. Creates complex financial estimates accurately and efficiently for patients shopping for healthcare services and for services scheduled at a Tri Health hospital facility, ambulatory site or provider offices; estimates can also include providers for which we do not bill for, adding to the challenge.

Coordinating financial clearance with insurance companies, providers and patients in an inbound/outbound call center setting. Make outreach calls to provide education to patients on insurance benefits, financial responsibility and financial assistance options, with a special focus on Out of Network plans. Ensures compliance with guidelines set by government programs and Tri Health policies, such as the federal regulations Price Transparency and the No Surprises Act.

High School Diploma or GED Degree or GED (Required)
3 - 4 years customer service experience (Required)
1 - 2 years of Clerical, Healthcare, Finance, and/or insurance industry (Required)
General Studies
Ability to operate multiple computer applications
Excellent verbal and written skills
Effective problem solving and critical thinking skills

Anticipates customer needs, problem solving skills, consistent and positive interactions with patients, internal customer and co-workers. Meets individual goal for call quality as measured by monthly call audits.
Completes assigned work queues/encounters to meet team deadlines.
Educates customers on coverage benefits, financial responsibility and provide consents as needed within policy guidelines, with timeliness being a key factor.
Exhibits knowledge and understanding of insurance benefits, financial assistance programs including, HCAP/Tri Health Financial Assistance guidelines and pricing.
Meets competency guidelines pertaining to government and Tri Health policy guidelines (Price Transparency, NSA, 501r, HCAP, etc…)
Accurately and timely documents benefits, estimates, and account notes in Epic and presents to patients in a timely fashion.

• Bending -
• Climbing - Rarely
• Concentrating - Consistently
• Continuous Learning -
• Hearing:
  Conversation -
• Hearing:
  Other Sounds -
• Interpersonal Communication - Frequently
• Kneeling -
• Lifting