Patient Financial Services Rep 1

Carle Health•Champaign, IL

About The Position

The Patient Financial Rep 1 researches, resolves, documents, and responds to inquiries about hospital and professional accounts from patients, insurance companies, attorneys, public agencies, internal departments, employers, and other third-party payers. The role handles incoming calls, face-to-face interactions, virtual visits, and written correspondence, including conference calls involving patients and insurance companies to resolve claims. It communicates billing processes, requests payments on balances due, establishes payment arrangements, validates insurance coverage, and addresses billing concerns. The position also provides financial counseling, conducts charity and presumptive eligibility screening, and helps patients apply for Carle Financial Assistance. It is responsible for cash drawer balancing and daily deposits, maintaining confidential records in compliance with HIPAA and organizational policies, and meeting departmental productivity, quality, and service standards. The role participates in departmental audits and reviews and escalates problem accounts as appropriate.

Responsibilities

Collaborate with internal departments, including insurance teams, charging, collectors, financial assistance, patient care, patient access, and coding, to resolve account discrepancies.
Research, resolve, document, and respond to patient account inquiries received by telephone, walk-in, virtual visit, MyCarle, or written correspondence.
Identify and resolve insurance coverage, registration, and billing errors to support accurate and timely billing and payment processing.
Identify and report needed account corrections, including guarantor number changes, double registrations, and other practice management system account build issues.
Resolve patient underpayments, no payments, overpayments, and undistributed payments for proper allocation.
Process one-time payments and establish payment plans in accordance with hospital guidelines.
Provide financial counseling, conduct charity screening through Experian, and assist patients with applying for the Carle Financial Assistance program.
Balance the cash drawer and complete the daily deposit.
Maintain confidentiality and comply with HIPAA regulations, including reporting potential HIPAA breaches and identity theft.
Recommend adjustments when applicable or recommend refunds for overpayments to insurance carriers or patients, with appropriate documentation.
Provide customer service to patients and insurance companies during conference calls.
Identify problem accounts and escalate them as appropriate.
Meet and exceed departmental productivity, quality assurance, and service excellence standards.
Perform other duties as assigned.