Patient Financial Services Representative

Are you looking for a career that offers both purpose and the opportunity for growth? Parkland Community Health Plan (PCHP) is a proud member of the Parkland Health family. PCHP is a Medicaid Managed Care Organization servicing Texas Medicaid and CHIP in the Dallas Service Area. PCHP works to fulfill of our mission by empowering members to live healthier lives. By joining PCHP, you become part of a team focused on innovation, person-centered care, and fostering stronger communities. As we continue to expand our services, we offer opportunities for you to grow in your career while making a meaningful impact. Join us and work alongside a talented team where healthcare is more than just a job—it’s a passion to serve and improve lives every day.

PRIMARY PURPOSE

Performs registration duties to include patient registration, obtaining precertification, obtaining proper authorizations, insurance verification and preliminary financial counseling services to ensure Parkland's financial viability at the most basic level.

MINIMUM SPECIFICATIONS Education

- High School diploma/GED

- Associate's degree preferred.

Experience

- Minimum of 2 years' experience within a hospital or clinical environment, an insurance company, managed care organization, other financial service setting, registration, financial counseling, financial clearance and/or customer service in a health care environment

. - General knowledge of patient access financial counseling functions in both acute and non-acute settings is a plus.

- Working knowledge of medical terminology and insurance terminology.

- Ability to work multiple computer systems such as patient, registration/accounting system, document imaging, scanning, proprietary payer websites and data quality monitoring, both accurately and efficiently.

- Prior experience in patient access, billing, cash collections, insurance, appointment scheduling preferred. - Knowledge and function and relationships within a hospital environment.

Equivalent Education and/or Experience

- May have an equivalent combination of education and experience to substitute for both the education and the experience requirements.

Certification/Registration/Licensure

- Certified Healthcare Access Associate (CHAA) preferred.

- Certified Patient Account Technician (CPAT) preferred.

- Certified Revenue Cycle Representative (CRCR) preferred.

Skills or Special Abilities

- Must be proficient in the use of personal computers, printers, scanners, etc.

- Must be able to demonstrate working knowledge of computer software, i.e., Word and Excel Knowledge, Hospital Information/Enterprise Systems, i.e., EPIC.

- Customer service skills and experience.

- Ability to work in a fast paced environment.

- Must be able to function in a high-level stressful environment while simultaneously multi-tasking.

- Ability to receive and express detailed information through oral and written communications.

- Professional approach and appearance.

- Detailed oriented with basic mathematical and analytical skills.

- Must be able to resolve registration issues as they relate to multiple groups including third party payors, system, patients and physicians.

- Knowledge of contract reimbursement, third party payors and insurance verification preferred.

- Ability to problem solve within the guidelines of established policies and procedures.

- Medical and insurance terminology.

- Bilingual skills preferred.

Responsibilities

1. Greets patients, family members, peers, and leadership in a professional, friendly, and respectful manner to promote a positive public image of Parkland. Willingness to move about the system to ensure all facets of the job responsibilities are completed accurately and timely to support the needs of the organization. Required to assist the hospital in the event of an internal or external disaster.

2. Obtain, verify, and update accurate demographic, financial, and insurance information in the process of registration. Including the entry of patient/guarantor information in the patient registration/accounting systems. Ensure accounts are billed accurately and timely. Guarantee that medical record numbers are not duplicated or overlays created.

3. Reviews patient accounts for financial status to identify non-funded and/or under-funded patients. Refers appropriate cases to financial counseling for follow-up and consultation and Case Management for clinical justification for pre-authorization as necessary.

4. Educate patients about financial liabilities, employs proper, compliant patient liability collection techniques before, during and after date of service. Performs cash reconciliation and secured payment entry in adherence to financial and cash control policies and procedures.

5. Clearly document actions taken in account notes to ensure information is available and understandable for other departments to review. Tracks productivity/quality and provides cumulative reports daily, weekly and monthly as required. Ensures Patient Rights & Responsibilities as well as other required documents are properly explained and presented to patients.

Job Accountabilities

1. Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.

2. Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.

3. Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and federal, state, and private health plans. Seeks advice and guidance as needed to ensure proper understanding

Parkland Community Health Plan (PCHP) prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.