The Financial Counselor I will provide administrative support functions for the departments for the Medical Clinic Care Center while providing excellent customer service to patients, families, outside agencies, and other customers. The incumbent will oversee and provide routine financial counseling for patients and families who receive services in assigned departments. Job functions and activities are periodically measured for adherence to quality and competency standards.

1. Verify, analyze, interpret, and document patient health insurance coverage, health plan provisions, or other third-party payment plan arrangements for outpatient and day treatment medical programs.
2. Conduct in-person or phone interviews with patient representatives to secure accurate information relative to financial status and cost of services. Obtain necessary referrals, authorization, and pre-certifications as needed. Obtain patient demographic data not captured during scheduling process.
3. Complete all online system entries and hard copy forms as needed.
4. Interview and counsel underinsured and uninsured patients, determine financial eligibility, verify insurance benefits, and perform financial case management. Secure authorization for outpatient medical programs.
5. Facilitate medically necessary correspondence with insurance carriers and other third-party payers.
6. Demonstrate understanding of basic business requirements of designated clinic and serves as a liaison between the clinic, the Care Center, the Patient Access Office, the Finance department, and customers.
7. Facilitate financial clearance for newly scheduled appointments through coordination with Care Center(s).
8. Evaluate funding sources and alternate funding sources of payment, following through until sources are exhausted or obtained.
9. Monitor insurance benefit thresholds (concurrent review) and facilitates the acquisition of additional authorization as directed by the Clinical Care Team.
10. Estimate deposit requirements, determine patient liability, establish payment arrangements, and coordinate payment arrangement information with Patient Accounting. Prepares cost estimates of services for families and agencies and facilitate negotiation of rates for outpatient programs and clinics based on insurance type and coverage.
11. Assist with the tracking of departmental reports, including Delinquency Reports, Medical Assistance Clearance Reports, bad debt reports, Medicare, and other insurance data tracking. Communicates solutions to leadership.
12. Review, evaluate, and coordinate health insurance benefits available through public and private health care coverage programs to ensure payment.
13. Forward all needed paperwork for outpatient procedures to Patient Registration Representatives to be added to account folder to ensure timely billing.

• High School Diploma or GED required.
• Bachelor’s degree in human services related field or health care administration preferred.

• Minimum two years of experience related to admissions and patient accounting in a healthcare setting required.

Kennedy Krieger Institute offers excellent benefits including medical, dental, vision, 401K with match, tuition reimbursement, free parking and child care subsidies!  In addition, we offer rich professional development opportunities. 

EOE/M/F/D/V