Patient Financial Services Representative

Rewarding career. Competitive salary. Outstanding benefits.

Patient Financial Services Representative is responsible for managing the full life cycle of a patient account, pre-visit through final resolution. This includes working closely with patients, internal departments, other providers, and insurance payers to ensure accurate billing, timely reimbursement, and a positive financial experience for patients.

This role supports hospital and clinic services in a Critical Access Hospital (CAH) environment and requires an understanding of payer benefits, revenue cycle workflows, and customer service excellence. Patient Financial Services representative serves as a key point of contact for both patients and providers, ensuring accounts are handled accurately, efficiently, and compassionately.

STANDARD EXPECTATIONS Promotes a Positive Working Environment Conducts oneself in line with organization’s mission, values and standards of behavior.

Accepts change and challenges with a positive attitude.

Consistently adheres to organizational policy.

Communicates Effectively Builds relationships and works collaboratively with other staff.

Provides timely operational updates to supervisor.

Responds to communications in a timely manner.

Performs Duties Efficiently and Effectively Follows procedures.

Acts in compliance with applicable federal, state, and local regulations.

Performs other duties as assigned.

AREA OF RESPONSIBILITY DUTIES & RESPONSIBILITIES Patient Interaction and Customer Service Serve as a primary point of contact for patient billing inquiries, providing clear and compassionate communication

Inform and assist patients with good faith estimates and prepayments prior to services

Educate patients on their financial responsibility, insurance coverage, and payment options

Assist patients with payment arrangements, financial assistance, and charity care processes

Resolve patient concerns promptly while maintaining a high level of professionalism and empathy

Accounts Receivable and Patient Follow-UpMonitor and review all Self-Pay Work Queues including Null, Follow-Up, Pre-Collect, Payment Plan, Pre-collect payment, Credit balance, Employee Review, Returned Mail, and Charity care Review and audit all uninsured accounts to ensure eligibility for insurance or charity care coverage and to establish payment plans

Escalate patient concerns as needed to Medical Biller or leader as appropriate

Research and resolve denials related to coordination of benefits, eligibility, or denials for patient information requested by the payer.

Identify trends and collaborate with internal teams to prevent recurring issues

Epic HB System Responsibilities Utilize Epic HB work queues, dashboards, and reporting tools to manage daily duties and A/R workload.

Maintain clear and compliant account documentation within Epic Identify Epic workflow issues or system errors impacting billing and reimbursement.

Participate in Epic upgrades, testing, and optimization efforts related to hospital billing and reimbursement.

Utilized Epic workflows to investigate and document all patient and guarantor activities

Compliance, Audit & Reimbursement Support Ensure billing practices comply with CMS, Medicare, Medicaid, State and payer regulations.

Support audits, payer reviews, and medical record requests related to hospital claims.

Assist leadership with data gathering and documentation related to cost report preparation and reimbursement analysis.

Adhere to hospital policies, HIPAA requirements, and billing compliance standards.

Team Support & Cross-Coverage Provide cross-coverage within the Patient Financial Services or Patient Access teams as needed.

Assist with patient billing inquiries related to hospital accounts in a professional and compassionate manner.

Participate in department meetings, training, and performance improvement initiatives.

QUALIFICATIONS Required

High school diploma or GED Excellent customer service experience

Strong computer skills in data entry, and knowledge of Microsoft Office Suite Preferred Minimum  of 1 years of hospital billing experience.

Understanding of patient benefits and hospital billing workflows.

Experience handling payments, cash posting, or financial transactions

Working knowledge of Epic Experience in patient facing hospital position WORK ENVIRONMENT AND PHYSICAL DEMANDS This position is primarily worked in an office environment. Primarily stationary with occasional standing, walking, lifting, reaching carrying, kneeling, bending, stooping, pushing and pulling of…