Financial Counselor
SummitStone Health Partners
Summary
Responsible for providing financial assistance and financial clearance support for clients receiving behavioral health services who are uninsured or underinsured, ensuring timely access to care. The Financial Counselor conducts comprehensive financial and benefits screenings, collects and reviews required documentation and determines eligibility for available payer sources and financial assistance programs, including Medicaid, the Discounted Fee Scale/charity care, and other applicable programs or grant funding. This role collaborates closely with inpatient and outpatient teams to verify coverage prior to service delivery, identify barriers to care, and support re-verification and renewal activities to prevent interruptions in coverage. The Financial Counselor provides individualized education and advocacy to help clients understand expected costs, billing processes, and their rights and responsibilities, while maintaining accurate, confidential documentation and required reporting. This position is trained and maintains competency as a Certified Application Assistant to directly support clients navigating the Medicaid application process and related state requirements.
Job description
Essential duties:
- Conduct financial screenings for uninsured or underinsured clients, including gathering, reviewing, and validating required documentation.
- Determine eligibility and identify appropriate coverage and assistance options (e.g., Medicaid, Discounted Fee Scale/charity care, other applicable programs, and grant funding) to support timely access to behavioral health services.
- For inpatient services, meet with uninsured or underinsured clients after admission to verify coverage, assess Medicaid application appropriateness, and identify available funding options.
- For outpatient services, complete financial clearance activities prior to service delivery by confirming coverage status, program requirements, and covered services; identify limitations or barriers that may delay access to care.
- Coordinate next steps with Clinical, Medical, Operations, and administrative teams by communicating coverage determinations, benefit limitations, and required follow-up in a manner that supports care coordination.
- Meet with clients via appointment (in person, on a unit or by phone) at point of entry to services and when circumstances change to complete re-verification, renewal, and ongoing eligibility activities to prevent interruptions in coverage.
- Educate and advocate for clients regarding expected costs, billing processes, and rights and responsibilities, ensuring understanding of any client liabilities associated with services.
- As a Certified Application Assistant, provide direct support to clients navigating the Medicaid application process and related state requirements; maintain required certification/competency.
- Maintain accurate, confidential documentation in the client record, including applications, verification documents, determinations (acceptance/denial), and all actions taken; create detailed notes to support continuity and compliance.
- Contribute to required data gathering, tracking, and reporting for financial assistance and departmental reporting needs.
- Support staff understanding of applicable billing and financial assistance workflows through guidance and education to administrative support staff and clinicians.
- Perform other duties as assigned.
Job Requirements:
- Detail oriented, with high-level problem solving, analytical, and investigational skills.
- Ability to work well independently, as well as in a team setting.
- Excellent written and verbal communication skills.
- Problem-solving and organizational skills.
- Proficient in Microsoft Office (Outlook, Word, Excel, and Power Point).
- Knowledge of CPT and ICD-10 codes, medical terminologies, billing software, and electronic medical records.
- Understanding of industry-specific policies, such as HIPAA regulations for health care.
Minimum Qualifications:
- High school diploma or completion of G.E.D required.
- More than two years of experience in healthcare billing practices or healthcare/medical insurance environment required.
Preferred:
- Associate’s degree or two-year college certificate in business administration, medical billing or related field preferred.
- Experience working with Colorado Medicaid will be an advantage.
- Mental health experience preferred.
- Bilingual/bi-cultural preferred.
Requirements
- High school diploma or completion of G.E.D required
- More than two years of experience in healthcare billing practices or healthcare/medical insurance environment required
- Detail oriented, with high-level problem solving, analytical, and investigational skills
- Ability to work well independently, as well as in a team setting
- Excellent written and verbal communication skills
- Problem-solving and organizational skills
- Proficient in Microsoft Office (Outlook, Word, Excel, and Power Point)
- Knowledge of CPT and ICD-10 codes, medical terminologies, billing software, and electronic medical records
- Understanding of industry-specific policies, such as HIPAA regulations for health care
Benefits
- Medical, Dental & Vision
- Mental health resources
- Short-term disability
- Long-term disability
- Paid time off
- Paid sick leave
- 403(b) retirement matching
Company overview
SummitStone Health Partners is a comprehensive mental health care provider organization dedicated to delivering integrated behavioral health services. As a leading healthcare provider in the mental health sector, the organization focuses on offering evidence-based treatment programs for individuals and families dealing with various mental health conditions, substance use disorders, and behavioral health challenges. SummitStone Health Partners operates with a patient-centered approach, providing a continuum of care that includes crisis intervention, outpatient therapy, medication management, and specialized treatment programs. The organization emphasizes accessibility and quality care, working to reduce stigma around mental health while promoting wellness and recovery. With a commitment to community-based services, SummitStone Health Partners collaborates with local healthcare systems and social service agencies to ensure comprehensive support for clients. Their multidisciplinary team of mental health professionals includes psychiatrists, psychologists, therapists, and support staff who work together to develop personalized treatment plans. The organization plays a vital role in addressing the growing need for mental health services and contributes to improving overall community health outcomes through innovative care delivery models and prevention initiatives.