Patient Benefits Representative Main Job Responsibilities:

Work directly with new patients to help them understand their mental health benefits, specifically pertaining to treatment plans at Emerald Psychiatry Work directly with new Self Pay patients regarding financial responsibility. Verification of patient insurance plans are compliant and in-network. Understand the patient's insurance, deductible, copay, coinsurance, etc. Provide exceptional patient care

Role Preview:

We're looking for a Patient Benefits Representative who combines a strong knowledge of healthcare insurance and medical billing with exceptional, compassionate customer service. You'll help patients understand their insurance benefits and insurance plans and financial responsibility, while serving as a trusted resource when insurance questions or concerns arise. The Opportunity Healthcare insurance can be confusing and frustrating for patients. The Patient Benefits Representative role exists to make it easier for our patients. The Patient Benefits Representative will serve as a trusted resource for new patients who have questions about their insurance benefits and insurance plans, and financial responsibility. You'll help patients understand what insurance plans and benefits they have available to them, and what their options are—while making sure they feel heard, respected, and supported throughout the process. You will have the important role of verifying patient insurance benefits and financial responsibility for all new patients. The ideal candidate is someone who understands the healthcare insurance language and is equally passionate about the patients we are helping. You don't simply verify an insurance plan—you investigate, educate, problem-solve, and communicate in a way that makes complex information easy to understand. This is a one-on-one patient interaction role that requires both healthcare insurance knowledge and outstanding customer service. What You'll Do Patient Financial Support Serve as a primary point of contact for new patients with questions regarding their insurance and financial responsibility. Utilize insurance company websites, portals, chats and calls to insurance to verify eligibility and benefit information. Help insured patients understand common insurance concepts including deductibles, copays, coinsurance, out-of-pocket maximums, allowed amounts, and patient responsibility. Help Self Pay patients understand their financial responsibility. Explain billing information in clear, straightforward, patient-friendly language. Help patients understand the difference between what a provider charges, what insurance allows, what insurance pays, and what the patient may owe. Research patient questions rather than simply directing them elsewhere whenever possible. Help patients understand payment options and available financial resources. Escalate complex billing, insurance, or account issues appropriately Insurance Billing and Patient Responsibility Develop a strong working knowledge of Emerald's billing processes, insurance contracts, payer requirements, and patient financial policies. Understand the basic healthcare revenue cycle from registration and insurance verification through claim submission, adjudication, payment, denial, and patient billing. Assist new patients with insurance-related questions and troubleshooting. Assist Self Pay patients with financial responsibility. Maintain accurate documentation of patient interactions and account activity. Protect patient privacy and maintain strict compliance with HIPAA and organizational policies. Exceptional Customer Service Approach every patient interaction with empathy, patience, professionalism, and respect. De-escalate difficult financial conversations and help patients feel heard. Recognize that conversations about money and healthcare can be stressful and sensitive. Adjust communication style based on the patient's level of understanding and comfort. Turn complicated healthcare terminology into language patients can actually understand. Take ownership of patient concerns and follow through until the issue is resolved or appropriately handed off. Create a positive experience even when the answer may not be what the patient hoped to hear. Build trust by being honest, transparent, and solutions-oriented. Represent Emerald's commitment to exceptional patient care in every interaction. Internal Collaboration Partner closely with Billing, Patient Access, Clinical, and Administrative teams. Communicate patient trends and recurring concerns to leadership. Help identify opportunities to improve billing communication and the overall patient financial experience. Provide feedback on patient-facing billing materials, processes, and communications. Participate in process improvement initiatives related to patient accounts and financial services. Support the development of consistent, patient-friendly language around billing and insurance. What We're Looking For Required Qualifications 2+ years of experience in healthcare billing, patient financial services, revenue cycle, insurance, patient accounts, or a related healthcare financial role. Working knowledge of medical billing and the healthcare insurance process. Understanding of insurance terminology including deductibles, copays, coinsurance and patient responsibility. Demonstrated ability to explain complex information clearly to patients or customers. Exceptional verbal and written communication skills. Strong customer service skills and a genuine desire to help people. Strong problem-solving and investigative skills. Ability to navigate difficult or emotionally charged conversations professionally. Strong attention to detail and accuracy. Ability to maintain confidentiality and comply with HIPAA requirements. Comfortable working independently while collaborating with a larger team. Familiarity with medical terminology, medical billing, and coding standards such as CPT coding, ICD-9/10 codes, and ICD coding systems. Preferred Qualifications Experience working in an outpatient medical, behavioral health, hospital, or physician practice environment. Experience working directly with patients regarding billing or insurance questions. Experience with insurance verification or benefits investigation. Experience working with Athena or other electronic health records (EHRs) and/or practice management systems. Experience with healthcare revenue cycle processes. Experience in behavioral health billing is a plus but not required. The Ideal Candidate We're looking for someone who is: Patient-centered. You genuinely care about helping people and understand that financial conversations can be stressful. A translator. You can take complicated insurance and billing information and explain it in a way that makes sense to someone who has never worked in healthcare. A problem-solver. You don't stop at "that's what the system says." You investigate, ask questions, and figure out what happened. Calm under pressure. You can work with frustrated patients without becoming defensive or taking difficult conversations personally. Accountable. When you say you'll follow up, you do. Detail-oriented. You understand that small billing or insurance details can have a significant impact on patients. A great communicator. You know how to be both honest and compassionate—even when delivering an answer a patient may not want to hear. Team-oriented. You understand that an excellent patient financial experience requires collaboration across the organization. What Success Looks Like In this role, success isn't simply measured by how many patient accounts you work.

Success looks like:

Patients feel respected and supported—even when they are frustrated. Billing questions are resolved efficiently and accurately. Patients don't have to repeatedly explain the same issue to multiple people. Insurance issues are identified and escalated appropriately. Patients trust Emerald to help them navigate the financial side of their care. You become a go-to resource for both patients and internal teams.

Pay:

From $24.00 per hour

Benefits:

401(k) Dental insurance Employee assistance program Flexible spending account Health insurance Health savings account Life insurance Paid time off Vision insurance

Work Location:

Hybrid remote in Dublin, OH 43017