Patient Financial Specialist

Omega Healthcare Management Services•Boca Raton, FL

1d•Remote

About The Position

The Patient Financial Specialist is responsible for conducting comprehensive patient intake, including collecting demographic, contact, and insurance information, and executing precise data entry into the Electronic Health Record (EHR) system for seamless billing. A key part of the role involves verifying active Medicaid coverage and benefits, assisting patients with Medicaid enrollment and renewals, and determining Coordination of Benefits (COB). The specialist will partner with third-party payers to resolve coverage discrepancies and provide empathetic, clear explanations regarding Medicaid benefits and billing inquiries. This role requires strong active listening and probing questions to resolve patient financial concerns, while maintaining meticulous patient records in strict accordance with HIPAA, HITECH, and JCAHO regulations. The ideal candidate will demonstrate the ability to prioritize, multi-task, self-motivate, set goals, and meet deadlines in a fast-paced, changing environment. Excellent verbal communication skills are essential for explaining complex billing and insurance concepts. The position requires proficiency in computer skills, experience with EHR/EMR or billing software, and an understanding of HIPAA and basic reimbursement principles. A high school diploma or equivalent is required, with 1-2 years of experience in medical billing, reimbursement processes, or insurance terminology, preferably in a healthcare customer service or call center setting.

Requirements

Ability to prioritize and multi-task in a fast-paced, changing environment.
Demonstrate ability to self-motivate, set goals, and meet deadlines.
Demonstrate excellent verbal communication skills, with the ability to effectively explain complex billing and insurance concepts to patients.
Strong active listening skills to understand patient concerns and provide appropriate resolutions.
Maintain courteous and professional working relationships with employees at all levels of the organization.
Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position.
Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.
Skill in operating a personal computer and utilizing a variety of software applications is essential.
Understanding of HIPAA and basic reimbursement principles.
Ability to work across multiple systems (EMR, PMS, digital portals).
1-2 years of experience in medical billing, reimbursement processes, or insurance terminology.
Proven background in customer service or call center environments (healthcare setting preferred).
Proficient computer skills and experience with electronic health records (EHR/EMR) or billing software systems.
High School diploma or equivalent.

Nice To Haves

Additional education in healthcare administration or related field is a plus.
Associate or bachelor’s degree in healthcare administration or a related field.
Prior experience specifically within the Epic ecosystem.
Familiarity with JCAHO, coding compliance, reimbursement, and HIPAA/HITECH.

Responsibilities

Conduct comprehensive patient intake by collecting demographic, contact, and insurance information.
Execute precise data entry into the Electronic Health Record (EHR) system to ensure seamless downstream billing.
Verify active Medicaid coverage and benefits through state portals and real-time eligibility tools.
Act as a patient advocate by assisting with Medicaid enrollment, renewals, and the gathering of required documentation (e.g., ID, income verification, and residency proof).
Determine Coordination of Benefits (COB) to identify whether Medicaid is the primary or secondary payer.
Partner with third-party payers to resolve coverage discrepancies.
Provide empathetic, clear explanations regarding Medicaid benefits, eligibility requirements, and billing inquiries.
Utilize active listening and probing questions to identify and resolve patient financial concerns.
Maintain meticulous patient records in strict accordance with HIPAA, HITECH, and JCAHO regulations.
Safeguard corporate and client assets by following all organizational security policies.