About the position
The Patient Financial Specialist (PFS) is responsible for all communications with the patients regarding their insurance and/or account with Privia Medical Group, as well as, all communications with third party payers regarding benefits and/or payment of services. They are responsible for performing any or all of the below mentioned duties as necessary based on the responsible parties involved.
Responsibilities
- Contact the patient prior to the visit to obtain/update the patient's demographic and insurance information.
- Enters/updates this information in POLCI.
- Contact the third party payer as needed to obtain required information pertaining to the patient's coverage for that visit.
- Obtain physician referral prior for office visit/procedure.
- Obtain all necessary verifications and referrals for Surgery accounts.
- Collect deposits, deductibles and/or co-pays prior to their surgery.
- Complete router with all pertinent information.
- Enter all information in the POLCI system insurance notes.
- Responds to patient’s requests regarding their account and explain Complete MD Solutions’ financial policy and procedures as needed.
- Work with patients to secure pre-payment sources or make other financial agreements prior to service/procedures.
- Process billing calls and questions and answers correspondence related to patient accounts.
- Assist in processing of insurance claims and resolving any coding or billing errors.
- Assist patients in completing all necessary forms and/or supply medical documentation as necessary.
- Participate with other staff to seek account resolutions.
- Follow up on unpaid claims and resubmits.
- Follow up with third party payers regarding claims concerning non-payments, reductions, down coding, etc.
- Audit all patient account transactions for accuracy and resolve any outstanding issues.
- Communicates with clinical, hospital and physician personnel related to patient accounts.
- Initiate requests for patient payments by telephone or letter.
- Audit all patient credit balance accounts for resolution.
- Make recommendations concerning accounts to be written off and/or turned over for collection.
- Post all actions related to the patient's account into the computer system as a permanent record.
- Request specific, non-generated routers through the Router Control Support Clerk.
- Print “Daily Activity Report” at close of day to ensure charge/payment re-entry activities are balanced.
- Substitute for other PSR’s as needed.
- Participate in educational and developmental activities.
- Attend meetings as requested.
- Perform other duties as directed by the supervisor.
Requirements
- 4+ years of Appointment Secretary experience, preferably in a OB/GYN medical office setting.
- 2+ years of PBX or call center experience.
- 2+ years of Athena EMR experience (Preferred).
- Basic computer literacy.
- Ability to handle yourself in a professional manner.
- Ability to accurately enter patient data into office software.
- Be a self-motivator and problem solver.
- 2+ years of comprehensive experience in a medical/physician office environment.
- 2+ years of medical collections experience.
- 1+ year of working knowledge of CPT and ICD-10 coding standards.
Nice-to-haves
- Athena EMR experience is preferred.
Benefits
- Confidentiality of information according to EEO guidelines.
