Patient Financial Services, Associate - Insurance

Stony Brook University•Town of Brookhaven, NY

1d•Onsite

About The Position

Under the direction of the PFS Team Lead and/or PFS Assistant Director, the Patient Financial Services (PFS) Associate is responsible for the accurate and timely review, billing, follow‑up, and resolution of assigned third‑party and/or patient accounts. This includes high‑dollar and complex service claims, ensuring that responsible payers are billed correctly and that payment is secured in accordance with payer requirements and organizational standards. The PFS Associate actively manages account activity throughout the revenue cycle by performing account analysis, follow‑up, and resolution, and by documenting all claim statuses, actions taken, and outcomes clearly and accurately within the patient accounting systems. The role requires independent judgment to identify billing errors, underpayments, and claim delays, and to take appropriate corrective action to promote clean claim resolution and timely reimbursement. The PFS Associate ensures a high level of customer satisfaction by providing timely, accurate, and professional responses to patient inquiries, requests for information, and claim appeals. This includes explaining account balances, insurance determinations, and billing outcomes in a clear and compassionate manner, while adhering to privacy, compliance, and customer service standards. In addition, the PFS Associate is responsible for identifying and analyzing complex claim issues, denial patterns, payment variances, and payer trends, and for communicating findings to leadership. The Associate escalates unresolved or high‑risk issues as appropriate and contributes recommendations to improve billing accuracy, workflow efficiency, and overall revenue cycle performance. This role requires a working knowledge of payer regulations, billing processes, and revenue cycle workflows, and plays a critical role in safeguarding hospital reimbursement and financial integrity.

Requirements

High School diploma or equivalent.
3+ years prior healthcare billing experience.
Knowledge of medical terminology.
Knowledge of Word and Excel applications.
Ability to adapt to system changes.
Ability to manage heavy call volume.
Self-starter.
Organized.
Detail-oriented.

Nice To Haves

College degree and/or certifications in billing and coding.
Bilingual.

Responsibilities

Accurate and timely review, billing, follow-up, and resolution of assigned third-party and/or patient accounts.
Management of account activity throughout the revenue cycle, including account analysis, follow-up, and resolution.
Clear and accurate documentation of all claim statuses, actions taken, and outcomes within patient accounting systems.
Identification of billing errors, underpayments, and claim delays, and taking appropriate corrective action.
Providing timely, accurate, and professional responses to patient inquiries, requests for information, and claim appeals.
Explaining account balances, insurance determinations, and billing outcomes clearly and compassionately.
Identifying and analyzing complex claim issues, denial patterns, payment variances, and payer trends.
Communicating findings to leadership and escalating unresolved or high-risk issues as appropriate.
Contributing recommendations to improve billing accuracy, workflow efficiency, and overall revenue cycle performance.