Patient Financial Counselor

Key Responsibilities:

1. Patient Financial Consultation

• Meet with patients and/or families to explain estimated costs for treatments, surgeries, and hospital stays.
• Clarify insurance benefits, co-payments, deductibles, exclusions, and non-covered services.
• Guide patients on available payment options, financial assistance, and hospital credit policies.

2. Insurance Verification & Coordination

• Verify insurance eligibility and coverage prior to admission or procedures.
• Coordinate with the TPA (Third-Party Administrator) desk or insurance companies for pre-authorizations and claim approvals.
• Maintain accurate records of approvals, denials, and policy details.

3. Cost Estimation & Billing Assistance

• Provide detailed cost estimates based on treatment plans and tariff codes.
• Assist patients in understanding final bills and outstanding balances.
• Work with the billing department to resolve discrepancies or billing issues.

4. Payment Planning & Collection

• Assist patients in setting up payment plans based on hospital policies.
• Collect deposits, advance payments, and post-discharge dues.
• Maintain records of payments and update billing systems accordingly.

5. Patient Support & Documentation

• Provide compassionate and confidential support to patients facing financial difficulties.
• Maintain detailed and accurate documentation of financial counseling discussions.
• Ensure compliance with hospital financial policies and data privacy regulations.

Qualifications & Experience:

• Education:

• Bachelor's degree in Commerce, Finance, Healthcare Administration, or related field
• Training in medical billing or hospital finance is an advantage

• Experience:

• 13 years of experience in healthcare billing, insurance, or patient coordination
• Experience with HIS (Hospital Information System) or billing software preferred

Skills & Competencies:

• Strong communication and interpersonal skills
• Knowledge of insurance policies, TPA coordination, and hospital billing practices
• Empathy, patience, and professionalism when dealing with patients and families
• Problem-solving and negotiation abilities
• Proficiency in MS Office and hospital ERP systems
• Fluency in local language(s) and English (written and spoken)