Patient Financial Services Specialist

The Patient Financial Service Specialist is responsible for providing patients with a positive financial experience by helping patients navigate and understand insurance benefits and potential financial liability. The Patient Financial Service Specialist handles inbound patient calls and assists with billing questions along with collecting payments and setting up payment arrangements. The Patient Financial Service Specialist is also responsible for accounts receivable functions to ensure maximization of cash flow while improving patient, physician, and other customer relations.

Patient Financial Service Specialist Job Duties and Responsibilities

• This position works within the operations of the billing department, and will be responsible for handling inbound phone calls and other forms of patient communication with courtesy, accuracy and respect for confidentiality.
• Answers inbound phone calls and other forms of patient communication by completing a full assessment of the account including reviewing documentation, insurance coverage, charges, chart, and payments.
• Obtains patient demographic data not captured during scheduling process, which is necessary for claims processing.
• Adds or updates insurance coverages to maximize insurance benefits.
• Makes outbound calls to collect patient balances by educating patient of their financial responsibilities, processing payments, and negotiating payment plans to ensure timely collection of patient balances.
• Demonstrates working knowledge of CPT/HCPCS codes, all facets of insurance claim filing requirements, regulations, and assigned departmental operating procedures ensuring consistency for customers.
• This position will assist in evaluating unpaid accounts. Works with the collection agency and small-claims court action accounts. Collects delinquent accounts, establishes payment arrangements with patients, and follows up to ensure that delinquent accounts are being paid.
• Maintains daily contact with other WHS departments, various third-party agencies, HMO/PPO’s, patients, their families, physicians, offices and other outside entities as needed.
• Exercises problem solving skills independently and update system to resolve any patient account delay
• Always handles all patient/family contact in a courteous, professional manner
• Consistently interacts with sensitivity to patients/their families and is responsive to individual needs
• Alerts Supervisor/Director to patterns in problem areas in order to initiate situation resolution
• Actively participates in and encourages others to utilize creative and innovative approaches to accomplish tasks
• Demonstrates responsibility for ongoing personal development, professional growth and continuing education
• Performs duties in a self-directed manner with minimal supervision or direction
• Ensures that routine and priority tasks are completed within established departmental time frames
• Demonstrates a clear understanding of and consistently adheres to department and facility policies and procedures
• Attends and actively participates in department and facility meeting and classes
• Follows safety procedures, operates equipment and performs job related duties in a safe manner which prevents accidents from occurring
• Participates in process improvement strategies and projects
• Other duties, as assigned.

Customer Service Standards

• Support co-workers and engage in positive interactions.
• Communicate professionally and timely with internal and external patients.
• Demonstrate friendliness by smiling and making eye contact when greeting all patients.
• Provide helpful assistance in anticipating and responding to the needs of our patients.
• Collaborate with patients in planning and decision making to result in optimal solutions.
• Ability to stay calm under pressure and deal effectively with difficult situations.

Work Environment/Physical Demands

• Climate controlled office
• Frequent sitting with movement throughout the office space
• Ability to move freely (standing, stooping, walking, bending, pushing and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance.
• Job classification is exposed to blood borne pathogens (blood or bodily fluids) while performing job duties.
• Occasional contact with aggressive and/or combative patients.
• Ability to work remotely as needed when approved by management
• Use of computers throughout the work day
• Frequent use of keyboard with repetitive motion of hands, wrists, and fingers
• Possible exposure to infectious specimens, communicable diseases, toxic substances, medicinal preparations and other conditions common to a medical office environment
• Wear Personal Protective Equipment (PPE) such as gloves or a mask
• Frequent interaction with a diverse population including team members, providers, patients and other members of the public.

Knowledge, Skills and Abilities

• Understanding of EPIC billing screens
• Has an expert level of knowledge regarding insurance benefits, coordination of benefits, insurance verification, benefits investigation and payer network participation.
• Working knowledge of common office computer programs; Word, Excel, Internet
• Ability to read and explain an explanation of benefits form from insurance carriers
• Ability to educate patients regarding their individual benefit plan, the practice Financial Policy, and our expectations regarding patient financial responsibility.
• Have ability to communicate effectively and assertively while demonstrating compassion and empathy for patient’s individual situations
• Ability to work independently in high volume, fast-paced, multi-tasking environment
• Ability to be flexible in response to unexpected changes in workload, staffing and scheduling
• Strong communication skills; both written and verbal
• Strong understanding and knowledge of HIPAA
• High attention to detail and strong problem solving skills

Education

• Associates degree in accounting, business, finance, medical billing, or related field, preferred.
• At least 1 year of previous healthcare revenue cycle and insurance experience
• Experience working with EPIC, at least 1 year preferred

Job relationships

• Close working relationship with front desk, billing and chartroom. MD's/PA's/APNP's.
• Strong communication and working relationship with other clinic staff-lab personnel, MD's/PA's/APNP's, nurses and ultrasound staff.
• Supervised by: Administration= Practice Administrator

Job Type: Full-time

Benefits:

• 401(k) matching
• Employee discount

Schedule:

• Monday to Friday

Work setting:

• In-person

Experience:

• patient financial service: 1 year (Preferred)
• EPIC: 1 year (Preferred)

Work Location: In person