Patient Financial Counselor

Description:

Job Summary

Cibola General Hospital is seeking a Patient Financial Counselor / Presumptive Eligibility Determiner to assist uninsured and underinsured patients in accessing healthcare coverage and financial assistance programs.

This position conducts Medicaid Presumptive Eligibility screenings, assists patients with Medicaid applications, and provides financial counseling regarding payment options and financial assistance programs. The role works closely with patients, clinical staff, and revenue cycle teams to ensure patients receive timely access to medically necessary services.

Responsibilities

• Assist patients in completing Medicaid applications through the YES-NM portal
• Provide financial counseling and discuss payment options with patients
• Identify patients who may qualify for Medicaid or hospital financial assistance programs
• Document patient encounters and eligibility determinations in the electronic health record (EHR)
• Work with clinical staff and internal departments regarding eligibility determinations and follow-up
• Ensure compliance with HIPAA, Medicaid guidelines, and hospital policies
• Provide excellent customer service to patients and families

Requirements:

QualificationsRequired

• High School Diploma or equivalent
• Strong communication and customer service skills
• Basic computer skills and ability to learn healthcare systems
• Ability to maintain confidentiality and handle sensitive patient information

Preferred

• Experience in healthcare billing, registration, or revenue cycle
• Experience with Medicaid eligibility or financial assistance programs
• Previous hospital or healthcare experience

Certification

Presumptive Eligibility Determiner certification required or must be obtained within the timeframe required by the New Mexico Human Services Department.

Work Environment

• Office setting within a hospital environment
• Frequent interaction with patients, families, and healthcare staff