Financial Counselor

Key Responsibilities:

Patient Financial Counseling & Education (Patient-Facing)

* Serve as the primary financial contact for patients, communicating with them directly regarding the insurance and financial aspects of their infusion treatment.

* Conduct patient welcome calls to introduce the financial counseling role, set expectations for the financial clearance process, and answer initial questions about coverage and costs.

* Obtain and confirm insurance coverage information and demographics prior to the start of treatment.

* Educate patients on their insurance coverage and verified benefits, including co-pays, deductibles, and out-of-pocket expenses, using benefit information provided by the BVPA team.

* Assess patients' ability to meet their financial obligations and identify those who may need financial assistance.

* Prepare and review cost estimates with patients, outlining their expected financial responsibility for infusion treatment based on verified benefits.

* Discuss payment options and set up payment arrangements with patients and ensure patient responsibility amounts are accurately recorded in the system prior to treatment.

* Answer patient questions about coverage, authorization status, and costs in a clear, compassionate manner.

Insurance Eligibility & Authorization Requirements

* Verify insurance eligibility and verify and update demographics and insurance coverage in the system according to established procedures.

* Track patients' progress through the financial clearance process.

Patient Financial Assistance

* Screen patients for financial assistance eligibility and refer or enroll those who express financial necessity in manufacturer copay assistance programs and/or foundation grants.

* Enroll eligible patients in manufacturer co-pay assistance programs, including completing enrollment, confirming activation, and monitoring program benefits and renewals.

* Complete grant and assistance applications on behalf of patients, gather required documentation in coordination with local teams, and follow up on application decisions and renewals.

* Stay current on available financial assistance programs and build professional relationships with manufacturer programs and foundations to identify additional resources for patients.

* Track enrollment and grant status and communicate confirmation of financial assistance enrollment to Infusion Coordinators so patients can be scheduled.

Communication, Collaboration & Documentation

* Communicate with patients and providers regarding the insurance and financial status of infusion orders.

* Work collaboratively with Infusion Coordinators, the BVPA team, and other central RCM colleagues to resolve financial barriers and keep orders moving.

* Document all patient, payer, and provider communications and financial activity in designated systems (e.g., Athena, WeInfuse) and maintain accurate logs and records.

* Adhere to HIPAA and all applicable confidentiality, state, and federal requirements regarding patient information.

Qualifications:

* High school diploma or equivalent; associate degree in finance or business, or equivalent revenue cycle experience, preferred

* Excellent verbal and written communication skills, including superior interpersonal and patient contact skills, excellent telephone manners, and the ability to explain insurance terminology clearly to patients

* Minimum of two years of patient benefits experience preferred, with experience in financial counseling, pre-service coordination, or insurance billing for medical services and general knowledge of ICD-10 and CPT codes; infusion or specialty medication experience is a plus

* Working knowledge of insurance coverage, benefits, and terminology (co-pays, deductibles, out-of-pocket maximums), and experience preparing patient cost estimates and arranging payment plans

* Experience with financial assistance, copay assistance, or grant applications is a plus

* Experience with, or ability to quickly learn, EHR and infusion management systems (e.g., Athena, WeInfuse)

* Knowledge of medical terminology and clinical documentation review

* Compassion and professionalism when discussing sensitive financial topics with patients

* Strong organizational skills

* Detail-oriented

* Ability to multi-task and work well in a fast-paced setting

* Critical thinking skills and decisive judgment

Work Environment & Location:

This position may be based in person at a clinic site or remote, and includes direct communication with patients by phone, virtually, and/or in person.