Job: PATIENT FINANCIAL SERVICES REPRESENTATIVE

Title PATIENT FINANCIAL SERVICES REPRESENTATIVE
Job Information

POSITION SUMMARY: The Patient Financial Services Representative is responsible for providing the patient with insurance and program education to ensure accurate information and excellent customer service. Responsibilities include: collecting required patient information and verify insurance eligibility, financial status and enrolling patients in state and clinic programs (if applicable), informing the patients of their out of pocket (OOP) costs and /or processing payment arrangements. In addition, the Patient Financial Services Representative will be responsible for obtaining referrals and authorization for clinic services, ensuring accurate, and timely information exchange with clinical departments, and collecting data for routine reporting.

REQUIREMENTS:

1. Certificate in Medical Office Administration with three years of relevant experience OR an Associate’s degree in health care, accounting or related field with two years of relevant experience. Bachelor’s degree preferred.

2. Must have a strong understanding of all major health insurance carriers, knowledge and experience working within insurance companies; must have strong computer, basic math, and decision-making skills.

3. Excellent verbal and written communication skills.

4. Must have exceptional interpersonal communication skills.

5. Must be able to effectively resolve conflicts.

6. Demonstrate professionalism in dealing with confidential and sensitive patient information. Comfortable discussing financial matters and asking for/requesting payment on past due accounts.

7. Detail oriented with ability to effectively prioritize tasks in a fast paced environment

8. Must have superior communication skills (reading/written/verbal) and organizational skills.

9. Exhibit a high level of courtesy, tact and poise with interacting with patients, co-workers, other internal customers, visitors and healthcare professionals

10. Cash management experience in order to process and request payments

11. Excellent computer skills, experience with Electronic Health Record system preferred

12. Able to work independently and as part of a team.

13. Ability to sit for long periods, and communicate over telephone while using computer.

14. Performs all job responsibilities in full compliance with all applicable laws, rules, regulations, policies and procedures.

RESPONSIBILITIES:

1. Knowledgeable of and applies the Vision, Mission, and Core Values of CareSouth.

2. Greets patients, visitors, and staff in a courteous, friendly, and professional manner.

3. Conduct interviews with patients and / or family members

4. Obtain relevant patient demographic information (i.e. address, phone numbers, insurance, etc.) and service information upon each visit.

5. Verify insurance coverage and benefits via online access or by phone in advance of a patient’s appointment.

6. Explain benefits to patients as well as staff, as applicable.

7. Obtain prior authorizations as applicable.

8. Assists eligible patients with completing Sliding Fee Applications.

9. Update patient demographic and insurance information in the EMR as applicable.

10. Send benefits applications to patients via email upon request to expedite verification processes.

11. Works collaboratively with Front Desk staff.

12. Refer uninsured patients to Outreach team for assistance with health insurance enrollment.

13. Perform appointment reminders and document the outcome/status in the Dentrix System.

14. Maintain confidentiality of patient’s protected health information.

15. Identify areas of improvement such as workflows and policies and processes.

16. Answers the phones as required.

17. Perform other duties as assigned by HIT/ Revenue Manager.

18. Advises self-pay patients of their medical and dental care options available.

19. Set up arrangements / monthly installment plans for patients to payoff balances within the guidelines of CSMD collection policy.

20. Maintains knowledge base of programs offered by CareSouth.

APPLICATION PROCEDURE:

Please submit a completed employment application found at www.caresouth.org/jobs or the HR office, resume, and credentials via email to jobs@caresouth.org or deliver to the HR office. CSMD is an EOE.

CLOSING DATE: Until filled.

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