Patient Financial Services Representative

JOB SUMMARY:

The basic function of the Patient Financial Services Representative is to work closely with the AR Department and Business Office to ensure timely claim submission and account follow-up, and to work closely with our patients to ensure 5-star customer service.

 

QUALIFICATIONS AND EDUCATION:

Education:

• High school diploma or equivalent is required.
• An Associate’s degree from a Medical Billing program is preferred.

Qualifications:

• 1-2 years of experience in insurance and billing procedures is preferred.
• Certified:
  • Professional certification through HFMA or AAHAM preferred.
• Must possess excellent organizational and time management skills.
• Must be able to prioritize duties and communicate directly with patients, physicians, co-workers and vendors. Must have professional telephone etiquette and have professional and effective communication skills.
• Excellent computer skills required. Must be able to work with internet options for claims processing and status checks.  Experience with Medent or CPSI software preferred.
• Must possess excellent working knowledge of medical insurance and billing procedures with understanding of HMO, PPO and indemnity plans. Must have working knowledge of entire billing process.
• Must be a team player and willing to work with all staff to get the job accomplished. Must maintain a cooperative working relationship with all co-workers and patients and handle difficult situations tactfully.
• In-depth understanding of contracts and proper payment methodology.
• Must have the ability to review and understand written material pertaining to Orthopedics and health care, including terminology and reimbursement issues.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Reviews and refers delinquent accounts for Collections.
• Processes checks received at OSS locations for daily deposit.
• Discusses payment arrangements with patients for outstanding patient balances.
• Runs reports of Daily Hospital Facility charges to ensure all charges are captured. Closes daily charges.
• Provides as-needed support for other patient accounting functions and special projects.
• Prepares patient statements.
• Processes account Insurance and personal refunds.
• Answers the billing hotline in a timely manner and assist patients who have billing questions and complaints
• Acts as a resource for internal customers concerning billing support. Serves as a resource for newly hired staff and new members of the department. 
• Processes requests for billing records from patients, third parties and law offices, following HIPAA guidelines.
• Resolves account To Dos in the billing system.
• Reviews and resolves Billing Group emails.
• Monitors incoming faxes in system and on manual fax machine.
• Demonstrates good judgment in safeguarding OSS information to include confidentiality of all medical and patient information.
• Follows all policies and procedures of OSS.
• Other duties as assigned.