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.

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

• 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.

• 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.