Patient Insurance Financial Counselor
Accounting & Finance, Legal
Posted on Friday, May 26, 2023
Ophelia's mission is to reinvent drug & alcohol rehab in America: to replace folklore with science, drug dealers with doctors, and stigma with privacy, convenience, and choice. We’re a diverse collective of hearts and minds - healthcare providers, scientists, technologists, and policy experts - backed by leading venture capital investors to re-imagine and re-build the addiction treatment industry from first principles.
Ophelia makes medical best practices for Opioid Use Disorder (OUD) private, convenient, and accessible, using a novel telehealth platform to provide FDA-approved medications, chronic support, and therapy at low cost. In December 2021, we raised a $50 million Series B Investment (Tiger Global, Menlo Ventures, Y Combinator, General Catalyst, and others) to expand nationally and grow our founding leadership team. We're also a certified Great Place to Work.
Join us, save lives, and help fix healthcare for those who need it most.
Ophelia is hiring an experienced Financial Counselor who will be assisting Ophelia’s patients with coordinating reimbursement sources and other activities related to securing reimbursement for services provided to patients who are either already in treatment, or who may be seeking to obtain services at Ophelia. We are looking for someone with experience in patient financial counseling and knowledgeable with government healthcare programs.
Communicate with patients to discuss the price of care and the patient’s current financial situation, obtaining all pertinent demographic and financial data to determine patient needs accurately.
Explain complex insurance topics such as benefit coverages, copays, deductibles, and coinsurance to patients.
Identify and understand patient needs to facilitate resolution of self-pay account balances.
Assist & track patients with payment plans, financial assistance, or other options to resolve patient account balances.
Acts as a resource and a guide to an uninsured patient with navigation of the process related to applying for all applicable financial assistance programs available such as Medicaid or Medicare.
Negotiate acceptable payment terms with patients in accordance with Ophelia’s policies and procedures.
Other duties as assigned.
2-4 years of current and relevant experience in financial counseling in a healthcare environment.
Knowledgeable of government healthcare programs and/or various payor guidelines and payment methodologies.
Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
Excellent communication and customer service skills & ability to effectively work with and resolve complex accounts & billing related issues.
A general knowledge of the revenue cycle and denial claim reasons.
Strong organizational skills with the ability to adapt, prioritize and meet deadlines.
Detail orientated, great team player, and enjoys working independently
Participate in regular team meetings; provide feedback and suggestions.
Excellent computer skills (preferably Google Docs) and experience utilizing various insurance web portals and computer applications.
Be willing and able to work in a fast-paced startup environment and who can easily adapt to increased business demands.
1. 75% Collection rate
2. Timely resolution of self-pay account balances
3. Identify areas of opportunity related to patient collections and patient financial assistance