Lead Patient Financial Representative

Lead Patient Financial Representative

This position is responsible for assisting with the day-to-day operations of Patient Access, ensuring that department functions are carried out with adherence to policy and procedures. This position actively engages in all work areas and provides training of the following job functions: registration, insurance verification, authorization, price estimation, denial prevention, claims processing, and financial screening. This role ensures feedback is provided to leadership regarding performance issues of team members and overall effectiveness of department policies to secure maximum reimbursement for the Health System. This position is also responsible for confirming patient identity and uses Epic and on-line resources to ensure Medicare medical necessity and billing requirements have been met. It also requires excellent verbal, analytical and customer service skills due to the varying methods of communication which occurs telephonically, in written form, electronically, in person, and bedside in a direct clinical care setting. Requires extensive governmental regulation adherence, computer knowledge and analytical experience to navigate and interpret information provided by a multitude of payers to ensure both claim and billing requirements have been completed, entered, and are accurate. This position also requires general payor contracting and chargemaster experience to ensure accurate price estimation to comply with governmental pricing transparency requirements. This job requires the ability to multi-task while using critical thinking skills to appropriately handle work complexity in a fast-paced work environment, while always providing an exceptional patient experience. This role contributes to the performance of the team by providing mentorship and guidance in the absence of management.

Education: High School Diploma or equivalent required. Post high school training or associate degree preferred.

Experience: Minimum of 2 years of healthcare/scheduling experience required. Epic experience preferred. Minimum of 1 year experience in customer relations role.

Certification: N/A

License: N/A

Other: Medical terminology knowledge required. Excellent computer skills. Ability to speak multiple languages is helpful. Knowledge and understanding of telephone etiquette including strong listening skills are essential. Excellent customer service skills are also required, including verbal and written communication.