Patient Financial Experience Rep

Metro Health | Wyoming, MI

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Posted Date 7/08/2019

Patient Financial Experience Rep - Professional Billing * Days - 40hrs/wk.

Requisition #: req1562

Shift: Days

FTE status: 1

On-call: No

Weekends: No

General Summary:

Under limited direction, the Patient Financial Experiences Rep is responsible to assist patients in resolution of Hospital and Professional billing and insurance concerns. In addition, Patient Financial Experiences Rep will aid patients in enrolling in Financial Assistance or supplemental payment plans such as Care Payment; provide charge estimates, and collect payments. Goal is to provide exceptional customer service to all callers while ensuring prompt, accurate reimbursement for services rendered.


  • Minimum high school diploma or GED required.
  • Two (2) years of experience working in an accredited hospital, physician office or medical call center.
  • Background in facility and professional claims resolution preferred.
  • Knowledge of medical terminology, ICD-10, CPT codes preferred.
  • EPIC or Revenue Cycle Certification a plus.
  • Ability to work independently with minimal supervision.
  • Excellent oral and written communication skills.
  • Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up.
  • Professional, business-like appearance and demeanor.
  • Recognizes and reports problems, errors and discrepancies to management.
  • Shares information with co-workers.
  • Ability to contribute to team efforts.

Essential Functions and Responsibilities:

  1. Provides exceptional customer service to all patients/callers by offering assistance and ensuring customer satisfaction.
  2. Answers inbound customer calls for at least 80% of the workday responding to inquiries with empathy and personal integrity.
  3. Handles challenging patients and customers effectively and professionally.
  4. Interpret insurance plan benefits and explain patient’s financial liability for deductible, co-insurance, and/or non-covered benefits.
  5. Provides charge and out-of-pocket estimates for medical services/procedures.
  6. Works closely with Hospital and/or Physician office staff to obtain correct information for billing purposes.
  7. Posts cash payments and reconcile vouchers according to department standard work plan.
  8. Review and interpret insurance plan benefits, explanation of benefits forms and validate the payments and adjustments made on accounts are correct.
  9. Maintains daily work queues according to payer requirements, including credit balances.
  10. Assists patients with enrollment in payment plans, Patient Financial Assistance and/or Care Payment.
  11. Responsible for quality and productivity standards established by management.
  12. Complete knowledge of payer guidelines, including utilization of payer websites and other tools.
  13. Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by management.
Job Type
Full time

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