SUMMARY

The Patient Financial Services (PFS) Representative will serve as a primary support to the organization’s patients regarding any concerns related to billing, self-pay balances, insurance payments, and all other financial matters. This position will also help in collection of patient payments, setting up payment agreements and assisting in portal services.

RESPONSIBILITIES

• Answer incoming patient phone calls and make outbound collection calls on open balances


• Update patient insurance, confirming eligibility and queue claims for billing


• Update demographic and guarantor information in the Patient Accounting System


• Act in a professional manner and treat patients, co-workers, and leadership with respect at all times


• Troubleshoot and identify patient billing issues to resolve them to patient’s satisfaction


• Ability to explain and discuss the organization’s policies for better patient understanding


• Educate patients about third party and insurance processes, their plan benefits, and how they affect patient balances


• Evaluate accounts from both an insurance and self-pay perspective


• Evaluate accounts for self-pay refunds


• Manage and work queues and worklists in patient billing system


• Advocate for patients and contact insurance companies on their behalf, when necessary, to resolve disputes


• Assist with patients with access to the Patient Portal and password resets


• Set up payment plans, monitor and make outbound calls to patients with broken promise to pay agreements


• Ability to approach patient and discuss open, unpaid or overdue balances


• Receive and process patient credit card payments, and allocate to appropriate visits on the account


• Evaluate accounts for bad debt placement and wok with bad debt vendor on patient issues and concerns


• Post appropriate discounts and adjustments to patient accounts


• Interact with supporting departments; coding, cash-ops, AR follow up to resolve billing and payment issues


• Interact with practices to communicate and work cooperatively regarding patient billing issues


• Maintain expected performance metrics

REQUIREMENTS

• Associates degree or relevant work experience required


• Medical billing experience in a professional setting required – either in AR/Follow up, Cash-Ops, denial management or self-pay role


• Athena and Meditech experience preferred; Experience with Excel, Word and Outlook required


• Knowledge of insurance rules/regulation and policies


• Strong communication and problem resolution skills


• Ability to identify billing trends affecting patient balances


• Ability to evaluate situations and escalate issues appropriately


• Ability to multitask, and ability to follow through with our patients and contacts


• Ability to read, understand and interpret insurance Explanation of Benefits

Organizational, time management skills