POSITION PURPOSE

The Senior Patient Financial Coordinator is responsible for performing advanced patient financial services functions, including billing, collections, accounts receivable follow-up, denial management, reimbursement analysis, and revenue cycle support. This position serves as a subject matter expert for billing processes, payer requirements, and revenue cycle workflows. The Senior Patient Financial Coordinator provides guidance and support to team members, assists with training and process improvement initiatives, and works collaboratively with clinical, patient access, health information management, and finance departments to ensure timely and accurate reimbursement while maintaining compliance with federal, state, and payer regulations.

KEY RESPONSIBILITES

Revenue Cycle Management Analyze and resolve complex billing and reimbursement issues. Monitor aging accounts receivable and prioritize high-dollar or high-risk accounts. Review claims for accuracy and completeness before submission. Ensure timely claim submission and follow-up with third-party payers. Research and resolve claim denials, underpayments, and payer discrepancies. Coordinate appeals and reconsideration requests for denied claims. Review reimbursements to ensure appropriate payment according to payer contracts. Accounts Receivable & Collections Perform advanced collections activities on outstanding balances. Identify trends affecting reimbursement and recommend corrective actions. Monitor payer response times and compliance with contractual obligations. Escalate unresolved payer issues as appropriate. Assist in reducing accounts receivable days and improving cash collections. Compliance & Quality Assurance Ensure compliance with Medicare, Medicaid, commercial payer, and regulatory requirements. Conduct audits of billing and collection activities to ensure accuracy and adherence to policies. Monitor compliance reports and address identified issues. Assist with internal and external audits as requested. Maintain confidentiality of patient information in accordance with HIPAA regulations. Leadership & Training Serve as a departmental resource for complex billing questions and payer regulations. Assist with onboarding and training of new Patient Financial Services staff. Provide coaching and support to team members regarding revenue cycle best practices. Participate in department meetings and process improvement initiatives. Assist supervisors with workflow coordination and special projects. Communication & Coordination Collaborate with Patient Access, Health Information Management, Clinical Departments, and Finance to resolve revenue cycle issues. Communicate effectively with insurance carriers, patients, physicians, and internal stakeholders. Document all account activity accurately within applicable systems. Participate in payer conference calls and reimbursement discussions when necessary. Administrative Responsibilities Maintain current knowledge of billing regulations, payer guidelines, and industry standards. Attend required education, training, and compliance sessions. Adhere to Medina Healthcare System's Code of Conduct. Perform other duties as assigned.

QUALIFICATIONS & EDUCATION

High school diploma or GED required. Associate degree in Healthcare Administration, Business Administration, Accounting, or related field preferred. Minimum of three (3) years of experience in medical billing, collections, revenue cycle management, or patient financial services required. Hospital billing experience preferred. Experience working with Medicare, Medicaid, commercial insurance payers, and denial management required. Knowledge of revenue cycle processes from registration through reimbursement preferred. Equivalent combination of education and experience may be considered.