Financial Counselor I in San Francisco, California at Wayward Medical Management Inc

POSITION SUMMARY
The Financial Counselor supports patients throughout the financial and insurance process for gender-affirming surgical care. This role is responsible for verifying insurance coverage, obtaining required authorizations, explaining benefits and estimated financial responsibility, and collecting patient payments (as applicable) before services are provided.
ESSENTIAL FUNCTIONS
Essential Responsibilities
• Verify patient eligibility, benefits, covered services, exclusions, deductibles, coinsurance, copayments, and out-of-pocket responsibilities.
• Review insurance benefits and estimated financial responsibility with patients in a clear, accurate, and compassionate manner.
• Conduct financial consultations with patients before initial consultations and surgical procedures.
• Obtain prior authorizations, referrals, and other payer approvals required for services and surgical procedures.
• Confirm that authorization requests include accurate procedure codes and required clinical documentation.
• Monitor pending authorizations and communicate status updates, additional requirements, or coverage concerns to patients and internal teams.
• Identify and resolve insurance discrepancies or authorization issues before surgery to reduce delays, cancellations and/or denials.
• Collect required deposits, outstanding balances, and self-pay amounts within established timelines.
• Accurately document insurance verification, authorization, financial counseling, and payment information in the appropriate systems.
• Coordinate with patient navigators, and Revenue Cycle teams regarding patient financial readiness.
• Provide patients with professional, respectful, and gender-affirming support throughout the insurance and financial process.
• Maintain regular and reliable attendance sufficient to meet the position’s operational, patient-service, and team obligations, with or without reasonable accommodation.
• Comply with applicable laws, regulations, accreditation requirements, privacy and security standards, and organizational policies relevant to the position.
• Other duties as assigned.
The essential functions listed are intended to describe the fundamental duties of the position. A qualified individual must be able to perform these functions with or without reasonable accommodation. The organization will engage in a timely, good-faith interactive process when an accommodation is requested or the need for accommodation is known.
MINIMUM REQUIRED QUALIFICATIONS
• High school diploma or equivalent.
• One year of customer service, healthcare administration, medical office, insurance, billing, registration, or related experience.
• Basic knowledge of medical insurance terminology and healthcare reimbursement concepts.
• Ability to communicate financial information clearly and professionally.
• Proficiency with electronic health records and standard office software.
PREFERRED QUALIFICATIONS
• Two years of healthcare financial counseling, insurance verification, patient access, or revenue cycle experience.
• Experience supporting surgical practices or specialty care.
• Bilingual capabilities.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.