Eligibility Counselor

Connect Health + Wellness is seeking candidates for a full-time Eligibility Counselor position for our Bassett, Virginia location. At Connect Health + Wellness, every position exists to advance our Mission—providing compassionate, high-quality care to uninsured and underinsured members of our community. As an Eligibility Counselor, your purpose is to reduce financial barriers and help patients access the care they need by offering guidance on payment options, insurance, and financial assistance. Every interaction you have should reflect our commitment to health equity, dignity, and service to others. Position Summary: The Eligibility Counselor serves as a key point of contact for patients at the Health Center and plays a critical role in ensuring a positive patient experience. This position requires a friendly and professional demeanor, along with the ability to communicate effectively with individuals from diverse backgrounds. In this role, you will help safeguard the Health Center’s financial stability by identifying payment sources, verifying insurance benefits, securing payment arrangements, and obtaining necessary authorizations for services. A core responsibility includes assessing patient eligibility for the Sliding Fee Discount Program, guiding them through the application process, and ensuring that all required documentation is obtained and reviewed according to policy. You will also support the accuracy and integrity of the Health Center’s financial and patient information systems through diligent data entry and documentation. The Eligibility Counselor collaborates closely with patients, families, providers, and interdisciplinary staff to ensure timely, equitable access to care while minimizing financial barriers. Success in this position requires a high level of accuracy, confidentiality, and independent initiative. The ideal candidate thrives in a fast-paced environment, is detail-oriented, and contributes positively to the culture of a Patient-Centered Medical Home, where teamwork, communication, and patient-centered care are at the heart of everything we do. Essential Functions of the Position Eligibility Counselor duties can include, but may not be limited to the following: Prepare for Daily Operations: Review upcoming appointments and patient accounts in advance of scheduled visits to identify financial counseling needs. Maintain Accurate Patient Records: Enter and update patient demographic, insurance, and financial information in the Electronic Medical Record (EMR) system with a high degree of accuracy. Verify Insurance Coverage: Confirm insurance eligibility at each visit, obtain authorizations as needed, and scan insurance cards into the EMR. Assist patients with updating their Primary Care Provider (PCP) on file with their insurance plan when necessary. Process Sliding Fee Discount Program Applications: Evaluate new and renewal applications for the Sliding Fee Discount Program, including those submitted outside of regular hours. Confirm patient eligibility and update EMR to reflect approved discount levels. Notify patients of expiring or incomplete documentation and assist with timely resubmission. Manage Proof of Income (POI) Documentation: Collect and scan acceptable POI documentation into the EMR. Communicate clearly with patients about applicable co-pays, sliding scale fees, or financial obligations. Coordinate with Front Office Team: Print and review the daily schedule to identify patients needing financial counseling. Communicate with front desk staff to ensure appropriate patient routine and handoffs. Conduct Patient Financial Consultations: Meet with patients upon arrival to review account status, collect co-pays or outstanding balances, and establish payment plans with required documentation. Educate patients on their financial responsibility and available assistance options. Facilitate Financial Hardship Applications: Provide hardship applications to qualifying patients, help in completing them, and ensure timely submission and follow-up. Collaboration on Financial Determinations: works closely with the Billing Director and/or CFO to review hardship requests and determine eligibility for financial relief or write-offs. Ensure Effective Communication: Maintain open and respectful communication with patients, staff, and external entities such as insurance companies. Route relevant financial or insurance documents to providers or billing staff as needed. Follow Organizational Policies and Regulatory Guidelines: Comply with all organizational policies and procedures, as well as regulatory standards including HIPAA, OSHA, and financial assistance policies. Demonstrate Core Competencies: Exhibit strong analytical, organizational, financial, and decision-making skills in all aspects of the role. Participate in Ongoing Training: Engage in required training related to EHR usage, effective communication, cultural competency, customer service, and compliance regulations. Additional Duties: Fulfill other responsibilities as assigned by the supervisor that align with the Mission and purpose Benefits: Paid Holidays (8) Paid Time Off (160 hours) Simple IRA Plan (with company match) Medical, Dental and Vision Insurance Life Insurance provided by employer Short-term and Long-term Disability coverage provided by employer Other voluntary plans available