Account Assistant 4, Pre-Estimations

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Overview

Under the general direction of the Yale Medicine Pre-Estimation Manager, the Financial Counselor plays a critical role in supporting patients through the financial aspects of their care journey. This position is primarily responsible for proactively engaging with patients to determine their financial responsibility and provide clear, personalized estimates of the anticipated costs for medical services prior to those services being rendered.

The Financial Counselor initiates direct communication with patients, via phone, secure messaging, or in-person consultations to explain insurance coverage, out-of-pocket obligations, and available payment options. They ensure patients understand the estimate by addressing questions, clarifying billing components, and offering empathetic guidance tailored to each patient’s financial situation.

In addition to providing estimates, the Financial Counselor is responsible for securing payment or establishing payment arrangements prior to service delivery. This includes discussing financial assistance programs, facilitating pre-service collections, and coordinating with clinical and administrative teams to ensure a seamless patient experience. Throughout the process, the Financial Counselor maintains a compassionate and professional demeanor, recognizing the stress financial uncertainty can bring and striving to empower patients with transparency and support.

Required Skills and Abilities

1. Superior oral and written communication skills. Independent decision-making.
2. Knowledge and thorough understanding of insurance benefits and ability to interpret and discuss deductibles and co-insurances with patients. Excellent customer service skills and work well as a team player.
3. Excellent attendance and reliability. Highly energetic and motivated with the ability to work under pressure and handle and maintain a high volume of accounts.
4. Ability to maintain a high degree of tact, diplomacy and understanding in dealing with patients and maintain a high level of confidentiality in discussing personal and financial matters.
5. Excellent organizational skills.

Preferred Skills and Abilities

At least two years medical billing and customer service experience. Working knowledge of medical insurance authorizations and referrals preferred. Working knowledge of ICD-10 and CPT codes. EPIC experience. Understanding of Credit Balance process in EPIC. Working knowledge of Microsoft Office. Spanish speaking preferred.

Principal Responsibilities

1. Serves as a principal source of information on rules and procedures governing University accounts receivable. Oversees and instructs support staff. 2. Oversees maintenance of account files, ensuring accuracy and completeness. Reviews payment histories. 3. Resolves problem and delinquent accounts with supervisor and collection agency. Assists with final review and disposition of problem accounts. 4. Recommends and implements changes to systems and operating procedures. Composes form letters and correspondence used in accounts receivable activities. 5. Researches individual accounts. Summarizes findings in reports. Completes and processes forms. Performs clerical functions incidental to account activity.

Required Education and Experience

Four years of related work experience, two of them in the same job family at the next lower level, and high school level education; or two years of related work experience and an Associate's degree, or an equivalent combination of experience and education.