Financial Counselor (Insurance Verification & Eligibility)

About the Role

We are seeking an experienced Financial Counselor to support our patients by coordinating reimbursement sources and demystifying insurance benefits. Approximately 80% of this role focuses on verifying, interpreting, and explaining insurance coverage.

The ideal candidate is a "benefits expert" who can navigate payer websites with ease and translate complex financial jargon into clear, supportive language for our patients. You will be the bridge between clinical care and financial clarity, ensuring our patients feel empowered rather than overwhelmed by their coverage.

Key Responsibilities

• Benefits Verification: Verify insurance eligibility using payer websites and online tools; ensure 100% accuracy of coverage details prior to and during treatment.

• Patient Communication: Clearly explain copays, deductibles, coinsurance, and out-of-pocket responsibilities to patients in a calm, compassionate manner.

• Escalation Management: Confidently lead difficult conversations and resolve escalated patient financial concerns with empathy and professionalism.

• Data Integrity: Accurately document all demographic and financial information to support clean claims and minimize downstream denials.

• Financial Solutions: Identify patient financial needs, establish payment plans according to Ophelia’s policies, and negotiate payment arrangements when necessary.

• Cross-Functional Collaboration: Partner with the billing and revenue cycle teams to improve processes and provide feedback on insurance trends.

About You

• Experience: 2–4 years of healthcare financial counseling or benefits verification experience

• Technical Expertise: Highly proficient in navigating insurance portals, payer websites, and online eligibility tools.