Financial Specialist – Pre Service

Job Responsibilities

• Completes work assignments within established quality standards.
• Communicates effectively with various audiences by using the most appropriate methods.
• Counsels patients on financial liability using available financial counseling tools to achieve maximum reimbursement for patient services.
• Verifies and enters insurance information and authorization/referral requirements.
• Contributes to a safe patient care environment by identifying, analyzing and effectively solving problems.
• Accepts responsibility to review and correct errors before completion and routes to others for review when appropriate.
• Educates and assists patients with the completion/submission of applications for alternative sources of payment for healthcare services such as medical assistance programs, loans and grants.
• Reviews documented insurance benefits and patient liability in appropriate systems to prepare for patient counseling sessions.
• Requests/secures balance due payments from patients in accordance with established policies and procedures.
• Educates/trains others on insurance theory, insurance verification, and authorization/referral processes.
• Participates in related process improvement activities and makes suggestions for new or revised policies and procedures.
• Demonstrates an understanding of account resolution processes such as benefit verification, insurance classification, billing complaint claims, and account follow-up.
• Stays current with relevant insurance, contractual, and/or third‑party payer regulations, medical policies, transaction/code sets, and general payment methods needed to ensure proper adjudication and compliance with industry standards.
• May perform additional duties as assigned.

• Experience – Two years of patient access experience
• Education – High School or GED

• Experience – preferred patient access or revenue cycle experience in multiple specialties or both hospital and clinic settings.

Demonstrates expertise in patient access and revenue cycle management, including insurance verification, financial counseling, and compliance with industry standards. Proficient in educating patients on financial responsibilities and navigating alternative payment sources.

• Patient Access Experience
• Insurance Verification
• Financial Counseling
• Revenue Cycle Management
• Process Improvement

• Insurance Information Verification
• Authorization/Referral Requirements
• Account Resolution Processes
• Billing Complaint Claims
• Benefit Verification

• Effective Communication
• Problem Solving
• Training and Education

• Healthcare Services
• Patient Liability
• Medical Assistance Programs
• Third‑Party Payer Regulations
• Contractual Compliance

• Financial Counseling Tools
• Patient Management Systems