Patient Financial Services Representative

INSIGHT Surgical Hospital•Coldwater, MI

23h

About The Position

The Patient Financial Services Representative supports hospital revenue cycle operations by performing patient billing, cashier activities, and financial counseling. The role helps ensure timely and accurate reimbursement for hospital services while providing a positive, patient-centered financial experience. The representative works with patients, clinical departments, and payers to support Medicaid eligibility, billing, and financial assistance programs, helping maintain access to care for diverse and underserved patient populations.

Requirements

High school diploma or equivalent required.
1–3 years of experience in hospital patient financial services, billing, or revenue cycle operations.
Familiarity with Medicaid eligibility and hospital-based financial assistance programs.
Knowledge of hospital billing systems and electronic health records (EHR).
Strong understanding of insurance processes, including Medicaid and Medicare.
Excellent customer service and communication skills in a healthcare environment.
Ability to manage multiple accounts and meet productivity standards.
Attention to detail, accuracy, and problem-solving abilities.
Ability to work in a fast-paced hospital setting.

Nice To Haves

Associate’s or Bachelor’s degree in Healthcare Administration, Business, or a related field.

Responsibilities

Perform payment posting, adjustments, and account reconciliation.
Monitor assigned hospital accounts receivable and follow up on unpaid or underpaid claims.
Investigate and resolve claim denials, coding issues, and billing discrepancies.
Ensure timely account resolution according to hospital billing guidelines.
Verify insurance coverage and Medicaid eligibility for hospital patients.
Assist with Medicaid enrollment, applications, and redeterminations for admitted and outpatient patients.
Submit and track Medicaid and third-party claims, including corrections and appeals.
Identify denial trends and escalate issues that affect reimbursement.
Explain hospital billing processes, insurance coverage, and patient financial responsibility.
Assist patients with charity care, financial assistance, and presumptive eligibility applications.
Collect required documentation and ensure applications are complete.
Set up payment plans in accordance with hospital policies.
Respond to patient and guarantor inquiries about hospital bills and insurance claims.
Provide clear, compassionate communication, especially in high-stress hospital situations.
Resolve routine issues and escalate complex cases to supervisors.
Maintain compliance with hospital policies, HIPAA, and federal and state regulations.
Ensure accurate and complete documentation in hospital billing systems.
Support audits by maintaining proper records and following internal controls.
Coordinate with all registration areas.
Communicate with insurance companies and Medicaid representatives to resolve account issues.
Support discharge planning by addressing financial clearance and eligibility needs.