Patient Financial Services Representative

Patient Financial Services Representative

For us, what matters most is excellence. We are caring professionals, people who live, work and dedicate themselves to the communities within New Jersey and Pennsylvania. As such, we strive to provide a sanctuary of excellence, precision, thoroughness and genuine compassion. We also take a whole-person approach to patient care and treatment, tailoring all that we do around their unique needs. And we do all we can for patients, going the extra mile to see that they're supported, informed and getting the one-on-one care and service they deserve.

Job Description:

As a key contributor to revenue cycle operations, a Patient Financial Services Representative plays a pivotal role in managing patient financial responsibility communication and collection. This role demands a dynamic individual capable of navigating complex insurance systems and contributing positively to the patient experience.

Essential Duties and Responsibilities

• Insurance Verification: Confirm patient insurance details, including detailed benefits, to ensure eligibility and secure financial reimbursement ahead of appointment dates. Responsible for verifying health insurance benefits for patients in advance of treatment. Consistently review eligibility responses in insurance verification system.
• Financial Clearance: Accurately review all patient demographic, financial, and insurance information, ensuring comprehensive financial clearance. This includes validating necessary referrals, authorizations, and pre-certifications to mitigate denials and secure reimbursement.
• Patient Communication: Inform patients/guarantors about their benefits, authorization needs, and out-of-pocket responsibilities, including co-pays, deductibles, and co-insurance through the full-cycle patient process. Collect treatment cost share in advance of appointments. Notify patient and help arrange alternative payment methods when insurance coverage does not cover services.
• Prior Authorization: Efficiently work with precertification team who handles prior authorization demands, and communication with patients regarding their out of pocket patient responsibility after insurance.
• Compliance and Communication: Maintain patient confidentiality, contribute positively to team dynamics, and engage in continuous professional development through meetings. Maintain service standards in accordance with the departmental/organizational policies.
• Collaboration with Teams: Collaborate with the office managers/office front desk team members, and patient accounts receivable vendors to coordinate outstanding patient balance concerns.

Competencies

• Communication: Exceptional verbal and written communication skills
• Analytical Proficiency: Strong critical thinking, analytical, and problem-solving abilities, coupled with excellent patient customer service.
• Excellent interpersonal skills and ability to work effectively with physicians, co-workers, other departments and patients, and across a broad range of cultural and social economic backgrounds.
• Ability to show tolerance and sensitivity in stressful situations and safeguard confidential information in accordance with established policies and HIPAA regulations
• Demeanor: Personable, outgoing, and friendly, fostering positive interactions and relationships.
• Work Ethic: Demonstrates flexibility and adaptability, capable of thriving independently and as an integral part of a team in dynamic environments.
• Self-Management: Ability to work independently in a fast-paced environment, maintaining professionalism and confidentiality in line with HIPAA regulations.
• Technical Skills: General computer skills, such as EMR, Microsoft applications, Outlook

Work Environment

• This position will be remote within New Jersey.

Requirements, Education and/or Experience

• High School Diploma or equivalent.
• Insurance Knowledge: Familiarity with insurance web portals for eligibility inquiries.
• Medical terminology and medical records experience.
• Can work closely with clinicians and outside entities.
• Well organized and have an understanding of oncology and hematology, preferred.

Pay Range: $26/hr - $30/hr

Pay Transparency: The above reflects the anticipated pay range for this position. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience.

We are proud to offer a comprehensive benefit package and paid time off. The health benefits include immediate eligibility for medical, dental, vision, life, disability, HSA, FSA and other ancillary benefits. We also offer a 401(k) plan with company contribution, profit sharing, tuition assistance and employee referral bonus.