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Patient Financial Service Representative
- Job Title
- Patient Financial Service Representative
- Job ID
- CHULA VISTA, CA
- Other Location
The Part-time Patient Financial Service Representative will insure that all processes related to insurance eligibility and verification are performed in order to have an individual insurance assessment for each patient and to discuss their financial responsibilities. This meeting will be held with each patient before or during the initial weeks of treatment, and will result in the collection of patient due amounts in full or an established payment plan.
- Responsible for collecting information related to each patient’s covered services and financial responsibility.
- Meet with patients to explain cost of treatment, insurance coverage, and patient financial responsibility.
- Responsible for monitoring and collecting the financial balances owed by our patients during their course of treatment.
- Coordinate insurance verification information amongst onsite and offsite staff to ensure correct balance is obtained, and/or estimate to be given.
- Provide a standard cost estimate to the patient within the initial weeks of treatment.Must be able to explain/differentiate between set commercial rates vs. Medicare/Medicaid allowable.
- The Patient Service Representative must use all information obtained to update patient financial records in our system to include data showing in both Centricity and the EMR.This information is shared by offsite billing and onsite Front Desk for the purposes of insurance and patient collections.
- Review all payment and financial options directly with the patient. Be sole contact for a Financial Assistance application and understand how to calculate poverty level from Federal Poverty Guideline provided.
- Assist patients with questions regarding billing, insurance and patient balances appearing on monthly billing statement.
- Monitor and update balances daily, to be forwarded to the front office staff detailing the amount of money to collect from each patient.
- Monitor Aging Balance report monthly, print new ABR quarterly, report to site leader upon request.
- Confirm Centricity demographic information to include HIPPA consent and billing release.Verify that proper diagnosis has been entered.
- Identify delinquent account balances in accordance with the patient’s treatment plan or with ongoing account balances.Meet with the patients in person at appointment to discuss Aging Balance or balance due.Call and send Balance letters as needed to keep account current.
- Ability to intervene in crisis situations - quickly and independently discerning financial interventions required - using sound analysis, professional judgment, ethical practice, and common sense.
- Work closely with the Patient Navigator and front office staff to ensure smooth collection process.
- Regular attendance and punctuality.
- Contributes to team effort by accomplishing related work duties as needed.
- Ensures that all processing and reporting deadlines are consistently achieved.
- Perform any other functions as required by management.
- Available to monitor front desk phones when primary job responsibilities are completed.
- Available to assist with patient insurance authorizations and monthly verifications as needed.
- Expected to assist with scheduling patients on all basis and demonstrating front desk coverage when needed.
Qualifications and Education Requirements
- Ability to work a flexible schedule as necessary.
- Two or more years experience in medical office setting working with medical insurance, coding and financial matters.
- Working knowledge of medical terminology as well as ICD-9 and CPT codes.
- Strong written/verbal communication, financial assessment, advocacy and crisis response skills, applied within established guidelines of the center.
- Associates Degree or an equivalent combination of education and experience.
- Insurance verification and/or budget/credit analysis and counseling experience.
- Bilingual in Spanish
Excellent judgment, dependability, conscientious performance. Detail oriented. Exceptional interpersonal and communication skills. Caring and empathic. High ethical standards. Mechanical ability and manual dexterity for operating complicated equipments.
Physical Demands and Work Environment
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical demands: While performing the duties of this job, employee is required to walk; sit; use hands to handle, or feel objects, tools, or controls; reach hands and arms; talk and hear. Employee must lift and/or move 50 pounds. Specific vision abilities required by the job include close vision, distant vision, color vision, peripheral vision, depth perception, speech clarity, climb, balance, and stoop, kneel, and bend.
Work environment: While performing the duties of this job, the employee is exposed to environmental risk of radiation exposure, and biohazard exposure.