Financial Counseling Representative

Date

3/2026

Department

Revenue Cycle/HIM

Shift

Days

Supervisor

Manager, Revenue cycle and Health Information Management

Job Summary

The Financial Counseling Representative serves as a key liaison between patients, payers, and clinical teams to ensure accurate insurance verification and clear communication of financial responsibility prior to services being rendered. Through proactive insurance verification/authorization and financial counseling, this position helps promote timely access to care while supporting revenue cycle integrity and patient satisfaction.

Key Responsibilities

1.

Verify patient insurance coverage, benefits, deductibles, co-payments, and authorization requirements prior to service.

2.

Identify coverage gaps or inaccuracies and work with Registration to correct demographic or insurance information.

3.

Communicate plan requirements (referrals, prior authorizations, out-of-network rules, upcoming coverage renewals) to patients/responsible parties, and clinical teams. Assist patient responsible parties with Medicaid eligibility and renewal requirements.

4.

Review payer portals and eligibility systems for real-time benefit information.

5.

Explain patient financial responsibility, including deductibles, co-insurance, co-payments, and non-covered services as needed.

6.

Offer guidance on payment options, financial assistance programs, and insurance alternatives.

7.

Screen patients for hospital charity care or financial assistance. Assist patients in completing applications and gathering required documentation.

8.

Maintain knowledge of federal, state, and hospital-specific assistance guidelines and eligibility criteria.

9.

Coordinate with outside vendors or Medicaid eligibility partners when applicable

10.

Establish payment plans following approved financial guidelines and obtain required signatures or agreements.

Patient Population Served:

Ranken Jordan is dedicated to delivering services to patients with complex medical needs, including infants, children, and adolescents.

Education and Experience Required:

·         High school diploma or equivalent required, associate degree in healthcare administration, business, or related field preferred. Certified Revenue Cycle Representative (CRCR), Certified Professional Biller (CPB), or comparable certification preferred.

·         Minimum 1-3 years of experience in healthcare financial counseling, patient access, registration or billing.

Knowledge, Skills, And Abilities

· Experience working with electronic health records (EHR), eligibility verification tools, and billing systems. Knowledge of Cerner/Oracle PowerChart a plus. Proficiency with Microsoft Office applications.

· Strong working knowledge of commercial insurance, Medicare, Medicaid, and managed care plans, including benefits, deductibles, co-payments, co-insurance, and authorization requirements.

· Familiarity with federal, state, and hospital-specific financial assistance, charity care, and Medicaid eligibility requirements.

· Ability to accurately explain financial responsibility and insurance requirements to patients/patient representatives in a clear, compassionate, and culturally sensitive manner.

· Proficiency in screening patients for financial assistance and charity care and assisting with application completion and documentation.

· Knowledge of HIPAA requirements.

Core Value Expectations:

·         Demonstrates professional conduct, appearance, and demeanor.

·         Communicates clearly and effectively in written, verbal, and listening formats.

·         Shows adaptability and a willingness to learn new systems, tools, and technologies.

·         Approaches work with a positive attitude and flexibility in managing assignments and shifting priorities.

·         Meets organizational expectations for attendance, punctuality, and reliability.

·         Understands and follows written and verbal instructions with clarity and accuracy.

·         Builds effective working relationships through strong interpersonal and collaboration skills.

·         Adheres to relevant organizational policies, industry standards, and regulatory requirements.

·         Adheres to Ranken Jordan’s Mission and Core Values.

Physical Demands:

Indicate the amount of time spent on each activity required as it relates to the essential functions

Physical Requirements

LBS

% of Time Spent

Physical Requirements

% of Time Spent

Carrying

0-35

5

Sitting

100

Lifting

0-35

5

Standing

20

Pulling

0-35

5

Walking

20

Pushing

0-35

5

Climbing

0

Bending

10

Writing/Typing

100

Grasping

20

Other (Specify)