Patient Financial Services Representative
About The Position
The Patient Financial Services Representative is responsible for managing the full life cycle of a patient account, from 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. The Patient Financial Services Representative serves as a key point of contact for both patients and providers, ensuring accounts are handled accurately, efficiently, and compassionately.
Requirements
- High school diploma or GED
- Excellent customer service experience
- Strong computer skills in data entry, and knowledge of Microsoft Office Suite
Nice To Haves
- 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
Responsibilities
- 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.
- Monitor 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.
- 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.
- 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.
- 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.
Benefits
- Medical, dental, vision, life insurance, and retirement options (403(b) & 457)
- Medical insurance coverage begins on day one and is available to both full time and part time employees.
- Discounts on medical services provided by Whitman Hospital and Medical Clinics.
- Differentials apply for evening, night, and weekend shifts.
- Unique PTO plan enables employees to increase their accrual with each year of service!
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
