Patient Financial Services Representative

Job Description

As a key contributor to revenue cycle operations, a Patient Financial Services Representative plays a pivotal role in managing patient financial responsibility communication and collection. This role demands a dynamic individual capable of navigating complex insurance systems and contributing positively to the patient experience.

Essential Duties And Responsibilities

• Insurance Verification: Confirm patient insurance details, including detailed benefits, to ensure eligibility and secure financial reimbursement ahead of appointment dates.
• Financial Clearance: Accurately review all patient demographic, financial, and insurance information, ensuring comprehensive financial clearance. This includes validating necessary referrals, authorizations, and pre-certifications to mitigate denials and secure reimbursement.
• Patient Communication: Inform patients/guarantors about their benefits, authorization needs, and out-of-pocket responsibilities, including co-pays, deductibles, and co-insurance through the full-cycle patient process. Collect treatment cost share in advance of appointments. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services.
• Prior Authorization: Efficiently work with precertification team who handles prior authorization demands, and communicate with patients regarding their out of pocket patient responsibility after insurance.
• Compliance and Communication: Maintain patient confidentiality, contribute positively to team dynamics, and engage in continuous professional development through meetings. Maintain service standards in accordance with the departmental/organizational policies.
• Collaboration with Teams: Collaborate with the office managers/office front desk team members, and patient accounts receivable vendors to coordinate outstanding patient balance concerns.

Competencies

• Communication: Exceptional verbal and written communication skills
• Analytical Proficiency: Strong critical thinking, analytical, and problem-solving abilities, coupled with excellent patient customer service
• Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments and patients, and across a broad range of cultural and social economic backgrounds
• Ability to show tolerance and sensitivity in stressful situations and safeguard confidential information in accordance with established policies and HIPAA regulations

Demeanor

• Personable, outgoing, and friendly, fostering positive interactions and relationships

Work Ethic

• Demonstrates flexibility and adaptability, capable of thriving independently and as an integral part of a team in dynamic environments

Self-Management

• Ability to work independently in a fast-paced environment, maintaining professionalism and confidentiality in line with HIPAA regulations

Technical Skills

• General computer skills, such as EMR, Microsoft applications, Outlook

Pay Range

Pay Range: $26/hr - $30/hr

Pay Transparency

The above reflects the anticipated pay range for this position. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. We are proud to offer a comprehensive benefit package and paid time off. The health benefits include immediate eligibility for medical, dental, vision, life, disability, HSA, FSA and other ancillary benefits. We also offer a 401(k) plan with company contribution, profit sharing, tuition assistance and employee referral bonus.