Financial Counselor

At Mahaska Health the Financial Counselor serves as a liaison between patients and available financial resources, assisting individuals in understanding and addressing their financial obligations for healthcare services. This role provides guidance on funding options and payment solutions, including but not limited to Medicaid, Financial Assistant and other financial assistance resources. The Financial Counselor works collaboratively with patients, families, healthcare providers, and external agencies to facilitate access to appropriate financial support, promote informed financial decision-making, and help minimize barriers to receiving care.

Essential functions include but are not limited to,

Patient Financial Counseling & Collections

• Assist patients with completing applications for presumptive Medicaid, Financials Assistance, and other available programs.
• Review daily inpatient, emergency room, surgical, and outpatient admissions identified as self-pay or underinsured to determine eligibility for financial assistance or governmental programs.
• Conduct financial interviews with patients and/or family members to obtain payment, establish payment arrangements, or determine eligibility for assistance programs.
• Process, monitor, and maintain payment plans, payroll deductions, and other payment arrangements in accordance with organizational guidelines.
• Process Financial Assistance applications and submit recommendations for approval according to established procedures.
• Generate and distribute patient notices, and financial assistance application materials according to departmental schedules.
• Perform collection activities through phone, written correspondence, and other approved communication methods while maintaining excellent customer service standards.
• Monitor accounts for delinquency and initiates appropriate follow-up actions in accordance with hospital policies.
• Research and process account adjustments and refunds in compliance with organizational policies and procedures.
• Assist with estate lien processes and documentation in accordance with applicable laws, regulations, and organizational procedures.
• Advise self-paying patients of available community resources, public health services, and other programs that may assist with future healthcare needs.

Insurance Verification & Financial Clearance

• Verify insurance eligibility, benefits, coverage limitations, deductibles, co-insurance, and other patient financial responsibilities.
• Utilize payer websites and direct communication with insurance carriers to obtain eligibility and benefit information for scheduled or proposed services.
• Calculate estimated patient responsibility and collect payments or establish payment arrangements in accordance with hospital policies.
• Collaborate with Registration, Case Management, Utilization Review, and Revenue Cycle departments to address patient status changes and financial responsibility determinations.

Account Maintenance & Documentation

• Maintain complete, accurate, and timely documentation of all account activities within designated financial and patient accounting systems.
• Process account reminders, follow-up activities, and work queues within established departmental timeframes.
• Run reports and perform account audits to identify and resolve registration, billing, and discharge discrepancies.
• Ensure recurring patients are appropriately discharged within designated systems and investigate unresolved account statuses.
• Monitor quality metrics and implement process improvements.

Bad Debt & Legal Recovery

• Prepare and file documentation necessary for small claims proceedings and other approved collection activities.
• Support bad debt recovery efforts through accurate account review, documentation, and follow-up in accordance with organizational policies and regulatory requirements.
• Monitor reports and account status indicators to ensure timely resolution of outstanding balances and billing exceptions.

Job qualifications include but are not limited to,

• High school diploma, GED, or equivalent required. Associate degree in Business, Healthcare Administration, Accounting, Finance, or a related field preferred.
• Previous experience in healthcare registration, patient accounts, financial counseling, medical billing, collections, insurance verification, or revenue cycle operations preferred.
• Knowledge of inpatient and outpatient hospital billing, insurance claim processing, reimbursement methodologies, and preferred governmental assistance programs.
• Experience working with electronic health records (EHR), patient accounting systems, and standard office software applications preferred.
• Proficient computer skills, including Microsoft Office applications and the ability to learn and effectively utilize hospital information systems.
• Working knowledge of medical insurance plans, including Medicare, Medicaid, commercial insurance, managed care organizations, and patient financial responsibility requirements.
• Strong organizational skills with the ability to manage multiple priorities, meet deadlines, and adapt to changing workloads.
• Ability to work independently while exercising sound judgment, discretion, and attention to detail.
• Excellent verbal and written communication skills with the ability to explain complex financial and insurance information in a clear and compassionate manner.
• Strong customer service skills with the ability to establish rapport and maintain professionalism in sensitive or difficult situations.
• Strong problem-solving and analytical skills with the ability to identify appropriate financial solutions for patients.
• Adhere to all confidentiality policies, including compliance with HIPAA and Mahaska Health training requirements.