Patient Financial Service PFS Representative

Core Functions

• Performs registration/check-in processes, including but not limited to performing data entry activities, providing patients with appropriate information and intake forms, obtaining necessary signatures and generating population health summary.
• Verifies insurance eligibility benefits for services rendered with the payors and documents appropriately.
• Affords assistance in obtaining or validating pre-certification, referrals, and authorizations.
• Calculates and collects patient liability according to verification of insurance benefits and expected reimbursement.
• Explains and provides financial policies and available resources for alternative payment arrangements to patients and their families.
• Enters payments/charges for services rendered and performs daily payment/charge reconciliation in a timely and accurate manner.
• Balances cash drawer at the beginning and end of the day and prepares daily bank deposit with necessary paperwork sent to centralized billing for record purposes.
• Schedules office visits and procedures within the medical practice(s) and external practices as necessary.
• Maximizes reimbursement by scheduling patients in accordance with payor plan provisions.
• Confirms patient appointments for the following day as necessary and ensures patients are properly prepared for visits.

Additional Related Education And/or Experience

• Work experience with the Company’s systems and processes is preferred.
• Previous cash collections experience is preferred.

Minimum Qualifications

• A high school diploma/GED or equivalent working knowledge.
• Knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience.
• The ability to manage multiple tasks simultaneously with minimal supervision and to work independently.
• Strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.
• Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

Position Summary

This position coordinates a smooth patient flow process by answering phones, scheduling patient appointments, providing registration of patient and insurance information, obtaining required signatures following established processes, procedures and standards. This position also verifies insurance coverage, validates referrals and authorizations, collects patient liability and provides financial guidance to patients to maximize medical services reimbursement efforts. This also includes accurately posting patients at the point of service and releasing information in accordance with organizational and compliance policies and guidelines.