Patient Financial Services Representative

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Position Description

Job Summary:

The Patient Financial Services (PFS) representative will serve as primary support to Petersburg Medical Center (PMC) patients regarding any concerns related to billing, self-pay balances, insurance payments, and all other patient financial matters. This position will also help in collection of patient payments, coordinating payment agreements and assisting in patient financial counseling.

RESPONSIBILITIES INCLUDE:

Technical or position specific duties/expectations

• Provide patients with outstanding service
• 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 PMC and PFS 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 information about the Patient Portal
• Set up payment plans, monitor and make outbound calls to patients
• Ability to approach patients 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 work with bad debt vendor on patient issues and concerns
• Post appropriate discounts and adjustments to patient accounts
• Interact with supporting departments; coding, third party billing company, AR follow up to resolve billing and payment issues
• Interact with all PMC staff to communicate and work cooperatively regarding patient billing issues
• Maintain expected performance metrics
• Other duties as assigned

Required Skills and abilities

o Excellent communication skills to include oral and written comprehension and expression.

o Ability and willingness to exhibit behaviors consistent with standards for performance improvement and organizational values (e.g., efficiency and financial responsibility; safety; partnership and service; teamwork; compassion; integrity; and trust and respect).

o Ability and willingness to exhibit behaviors consistent with principles for service excellence.

o Awareness of philosophy of care as it relates to Patient Financial Services.

o Demonstrate knowledge of current resources and programs to assist the patient’s need for financial resources, i.e., medical assistance programs.

o Demonstrates ability to act with sensitivity as a patient advocate.

o Promotes the mission, vision and values of Petersburg Medical Center by modeling excellent teamwork, attitude, and by providing excellent patient and resident centered care.

o Maintains customer focus in all decision-making, develops an understanding of customer perspective and strives to exceed customer expectations.

o Highly collaborative team player engaged in the task and the mission of the position.

o Respectful and positively communicates with all customers and co-workers.

o Fosters an environment that promotes trust and cooperation.

o Ability to adapt to changing expectations, supports other members of the team to meet the mission of the department.

o Continually seeks to improve processes that have a direct impact on the quality care and services provided.

o Provides services in a safe manner to protect themselves, their co-workers and their patients.

o Consistently acts in an honest, ethical and trustworthy manner and complies with Federal and State laws regarding all matters of a confidential nature.

o Adheres to all policies, procedures and the Code of Conduct of Petersburg Medical Center.

o Ability to identify billing trends affecting patient balances

o Ability to read, understand and interpret insurance Explanation of Benefits (EOB)

QUALIFICATIONS, TRAINING AND EXPERIENCE

High School graduate required, college courses helpful. Medical billing/Patient Accounting experience preferred. Experience with Excel, Word and Outlook, Evident EMR experience preferred. Must meet all training requirements for specific department.

• Able to deal with high demand, fast-paced, multi-departmental hospital needs. The individual must be highly organized and task oriented.
• Must possess the ability to prioritize responsibilities and handle multiple requests simultaneously.

ACCOUNTABILITY

This position reports to Business Office Manager.