Patient Financial Services Rep 1

Carle Health•Champaign, IL

About The Position

The Patient Financial Services Rep 1 researches, resolves, documents, and responds to inquiries about hospital and professional accounts from patients, insurers, attorneys, public agencies, internal departments, employers, and other third-party payers. The role handles incoming calls, in-person interactions, virtual visits, and written correspondence, including escalated conference calls between patients and insurance companies to resolve claims. It communicates billing processes and financial obligations, requests payment on balances, arranges payment plans, validates insurance coverage, and addresses billing concerns. The representative provides financial counseling, screens patients for charity and presumptive eligibility, and assists with applications for Carle Financial Assistance. The role also processes payments, balances a cash drawer, and makes the daily deposit. It requires accurate, confidential recordkeeping in accordance with HIPAA and organizational policies, along with meeting departmental productivity, quality, and service expectations and participating in audits and reviews.

Responsibilities

Research, resolve, document, and respond to patient account inquiries received by telephone, in person, through virtual visits, MyCarle, or written correspondence.
Collaborate with internal teams, including insurance, charging, collections, financial assistance, patient care, patient access, and coding, to resolve account discrepancies.
Identify and resolve insurance coverage, registration, and billing errors to support accurate and timely billing and payment processing.
Identify and report account corrections involving guarantor number changes, duplicate registrations, and other practice management system account-build issues.
Resolve patient underpayments, nonpayments, overpayments, and undistributed payments; recommend adjustments or refunds when appropriate and provide supporting documentation.
Process one-time payments and establish payment plans according to hospital guidelines.
Communicate billing processes, request payment on outstanding balances, validate insurance coverage, and address billing concerns.
Provide financial counseling, conduct charity screening through Experian, and assist patients with applications for Carle Financial Assistance.
Balance the cash drawer and complete the daily deposit.
Maintain confidentiality and comply with HIPAA regulations, including reporting potential HIPAA breaches and identity theft.
Provide customer service to patients and insurance companies, including participating in conference calls.
Identify problem accounts and escalate them as appropriate.
Meet departmental productivity, quality assurance, and service excellence standards; participate in departmental audits and reviews.
Perform other duties as assigned.