Patient Assistance Counselor

Job Description

Job Description

The Patient Assistance Counselor (PAC) plays a crucial role in interviewing and verifying insurance benefits for uninsured and underinsured patients, as well as following up on referrals to assess and address patient and member needs. This position involves carefully reviewing financial and medication assistance applications to ensure compliance with grant and other program funding requirements. Additionally, the Patient Assistance Counselor maintains a comprehensive understanding of healthcare coverage options available through local, state, and federal programs. They actively engage in outreach and enrollment efforts to connect patients with these essential resources, ensuring that individuals receive the support they need to effectively understand their healthcare options and benefits.

ESSENTIAL JOB FUNCTIONS

• Documents interactions with patients via phone or in person and defines the action(s) taken for the purpose of recording these encounters for future reference.
• Conducts outreach and enrollment activities to bridge patients to available health care and medication programs / grants and interacts with various internal and external resources to ensure patient referral needs are met.
• Reviews Financial Assistance and medication assistance applications to ensure completeness and program requirements are met.
• Assists with the approval or denial of Financial Assistance applications within a specified dollar amount to help facilitate timely processing of applications.
• Reviews applicants’ outstanding account balances to determine which balances can be included in the Financial Assistance award, including balances referred to other agencies.
• Calculates income and asset totals to determine the Financial Assistance award level.
• Reviews applicants’ accounts for existing payment plans and terminates the plan to avoid further collection measures while the Financial Assistance application is being reviewed.
• Reviews accounts to determine individual patient eligibility for assistance through outside financial programs and monitors for ongoing assistance.
• Maintains financial and social case management programming statistics for grant program purposes.
• Regular attendance is required in order to carry out the essential functions of the position.
• Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.

JOB QUALIFICATIONS

EDUCATION

For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

Minimum Required : High school diploma or equivalent.

EXPERIENCE

Minimum Required : One year experience in medical business office, insurance, or healthcare setting, or comparable experience.

CERTIFICATIONS / LICENSES

The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.

Minimum Required : For positions hired within the FHC dental centers :

Certified Application Counselor (CAC) designation through the Centers for Medicare and Medicaid Services within three months from the start of the first CAC training period, offered after hire. Employees hired less than three months before the start of the CAC training period may defer their attendance and certification exam until the following year.

Equal Opportunity Employer

Monday thru Friday; 8am-5pm

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