Patient Insurance Benefit Specialist II

Evaluating and Communicating Patient Financial Responsibility

Evaluates and communicates patient financial responsibility prior to and after services, including cost estimates and collection of co-pays, deductibles, and co-insurance.

Financial Counseling and Payment Arrangements

• Provides financial counseling and negotiates payment arrangements, ensuring compliance with billing and collection regulations.

Insurance Verification and Administration

• Verifies insurance benefits, obtains authorizations, and maintains expertise in third-party payor processes and terminology.
• Administers financial assistance programs, including hospital charity policies, the Colorado Indigent Care Program (CICP), and Medicaid application support.

Account Audits and Resolution

• Solves patient inquiries, conducts account audits, and supports billing accuracy, refunds, and adjustments.

Customer Service and Collaboration

• Delivers high-quality customer service while collaborating with internal teams, payors, and external partners.

Position Summary

This role supports patients and families in navigating the financial aspects of care while ensuring accuracy and compliance across the revenue cycle.

Position Highlights

• Evaluates the patient’s potential financial liability prior to and after medical services have been rendered.
• Works with patients and their families to evaluate financial data and determine ability to pay under all payors, negotiating payment arrangements and administering hospital and state financial assistance programs.