Patient Access Rep – Financial Counselor- TMCH Cancer Center

SUMMARY:

The Patient Access Rep - Financial Counselor is responsible for assisting patients and their families in understanding and managing the financial aspects of their healthcare. This includes verifying insurance coverage, estimating out-of-pocket costs, arranging payment plans, and identifying financial assistance programs. The role ensures compliance with hospital policies and regulatory requirements while delivering compassionate and informed support to patients.

ESSENTIAL FUNCTIONS:

· Interview patients or their representatives to assess financial status and determine payment options.

· Verify insurance eligibility, benefits, and authorization requirements.

· Provide cost estimates and explain patient financial responsibility.

· Collect deposits, co-pays, and deductibles; establish and monitor payment plans.

· Assist patients in applying for financial assistance, charity care, or third-party funding.

· Ensure completion of financial documentation in accordance with hospital policies.

· Perform medical necessity screening and ensure compliance with system requirements.

· Collaborate with clinical departments and physician offices to obtain necessary documentation.

· Maintain accurate records and documentation in EHR and financial systems.

· Prepare daily deposits and reconcile financial transactions.

· Adhere to HIPAA and organizational confidentiality standards.

· Performs related duties as assigned.

 

MINIMUM QUALIFICATIONS

 

EDUCATION: High school diploma or GED required; associate degree or vocational training in healthcare or finance preferred..

 

EXPERIENCE: Three (3) years in a healthcare or medical office setting, including experience in insurance verification, financial counseling, or patient access.

 

LICENSURE OR CERTIFICATION: None required; CHAA or related certification preferred.

 

 

KNOWLEDGE, SKILLS, AND ABILITIES:

· Knowledge of healthcare billing, insurance plans, and financial assistance programs.

· Strong interpersonal and communication skills.

· Ability to explain complex financial information in a clear and compassionate manner.

· Proficiency in EHR systems, payer portals, and Microsoft Office.

· Attention to detail and accuracy in documentation.

· Ability to manage multiple tasks in a fast-paced environment.