Patient Financial Representative

About the role

This position completes and assists with registration, insurance verification, authorization, price estimation, denial prevention, claims processing, and financial screening to secure maximum reimbursement for the Health System.

Responsibilities

• Completes and assists with registration, insurance verification, authorization, price estimation, denial prevention, claims processing, and financial screening to secure maximum reimbursement for the Health System.
• Confirms patient identity and uses Epic and on-line resources to ensure Medicare medical necessity and billing requirements have been met.
• Ensures compliance with governmental regulations and accurately navigates and interprets payer information to complete, enter, and maintain accurate claims and billing requirements.
• Navigates and interprets information from a variety of payers to ensure both claim and billing requirements have been completed, entered, and are accurate.
• Collaborates with the Care Management and Utilization Management team to ensure ongoing concurrent authorization and patient discharge planning needs are met.

Requirements

• Education: High School diploma or equivalent required. Post high school training or associate degree preferred.
• Experience: Minimum of 1 year of experience in customer relations role. Minimum of 2 years of revenue cycle experience, Epic experience preferred.
• Certification: N/A
• License: N/A
• Other: Medical terminology knowledge required. Excellent computer skills. Ability to speak multiple languages is helpful. Knowledge and understanding of telephone etiquette including strong listening skills are essential. Excellent customer service skills are also required, including verbal and written communication.