Patient Financial Specialist

Position Purpose The Patient Financial Specialist III performs all the functions of a PFS II. In addition, the PFS III performs verification of prior authorization and obtaining precertification for selected scheduled services. Also, this staff member is proficient in scheduling complex procedures from the physician’s office as well as complex and changing insurance/reimbursement requirements. Employment Details Type: Full time Shift: Monday - Friday 7:30am - 4:00pm Location: Mount Carmel East, Radiation Oncology Responsibilities Performs activities that relate to patient scheduling, pre‑registration, real‑time eligibility verification, insurance authorization, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other intra‑departmental functions. Determines proper scheduling requirements and/or limitations according to requested test(s)/procedure(s) and schedules resources (equipment, staff, room, etc.) in a timely manner to ensure customer satisfaction, maintain patient flow, and appropriate utilization of the service area. Coordinates add‑on and same‑day appointments with the service area, as required. Ensures proper test sequencing with minimal patient delays when multiple testing is required. Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions. Communicates with various ancillary departments to ensure an accurate schedule and that all reports are properly distributed. Validates medical necessity (LMRP/LCD review) of Medicare and Non‑Medicare cases to ensure clinical and financial clearance. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s). Requirements / Qualifications High School Diploma. Working knowledge of medical terminology and data entry skills. At least two (4) years’ experience within a physician office, hospital or clinic environment, performing patient scheduling and precertification activities. Proven experience in at least two of the following areas: Web and fax orders, Outpatient IV scheduling, Complex physician office scheduling such as wound care and physician‑performed procedures, or precertification. Excellent interpersonal skills, accuracy, attention to detail and time‑management skills. Position Highlights and Benefits Mount Carmel Health System recognized by Forbes in 2025 as one of America’s Best State Employers. Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one. Retirement savings account with employer match starting on day one. Generous paid time off programs. Employee recognition programs. Tuition/professional development reimbursement starting on day one. RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing. Relocation assistance (geographic and position restrictions apply). Employee Referral Rewards program. Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups. Equal Employment Opportunity Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person‑centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. #J-18808-Ljbffr