Patient Finance Rep

Position Summary/ Department Summary:

Ensures all required demographic, insurance and referral data is collected, verified, entered and communicated appropriately. Collaborates with physician offices, service sites, ancillary departments and insurance representatives to proactively complete patient financial clearance. Identifies trends, denials, issues impacting account resolution or workload, and refers as appropriate.

Key Responsibilities:

Manages daily assignments using standardized protocols and work queues to ensure timely completion of financial clearance in accordance with departmental processes and payer guidelines. Collects, verifies, and records all demographic information required for patient financial clearance in accordance with hospital policy. Verifies insurance eligibility using available technologies, payer websites, or by phone contact with third party payers. Works in accordance with required State and Federal regulations and hospital policies. Ensures that correct insurance company name, address, plan, and filing order are recorded in the patient accounting system. Utilizes payer exception reports to update coverage / PCP information. Contacts PCP (primary care physician) offices to secure referrals and enters referrals into patient accounting system. Documents all actions taken on accounts with clear and concise account notes. Participates in process improvement activities.

Minimum Qualifications Education:

High school diploma or GED required.

Experience:

Ability to communicate effectively in English both orally and in writing and provide empathy in difficult interpersonal situations. Ability to resolve moderately complex problems requiring the use of basic scientific, mathematical, or technical principles is required. Good customer service skills and a basic understanding of computer systems are required. Familiarity with basic medical terminology is preferred. Ability to work as part of a team with diverse internal and external constituencies.