Job Summary
The Senior Patient Financial Representative is responsible for managing patient financial interactions, including billing, collections, and insurance verification. This role ensures accurate processing of patient accounts, provides financial counseling, and supports patients in understanding their financial responsibilities. The representative serves as a key liaison between patients, providers, and insurance companies to maintain compliance and ensure timely reimbursement.
Key Responsibilities
- Review and process patient accounts for accuracy and completeness.
- Verify insurance coverage and benefits, ensuring proper documentation.
- Provide financial counseling to patients regarding billing, payment options, and insurance claims.
- Assist patients with resolving billing inquiries and discrepancies.
- Coordinate with insurance companies to ensure timely claim submission and reimbursement.
- Monitor outstanding accounts and follow up on collections as needed.
- Maintain compliance with hospital policies, payer requirements, and regulatory guidelines.
- Document all patient interactions and account updates in the system.
- Collaborate with clinical and administrative staff to support patient care and financial processes.
Required Qualifications
- High school diploma or equivalent required; Associate’s degree in business, healthcare administration, or related field preferred.
- Minimum of 3–5 years of experience in patient financial services, billing, or collections.
- Strong knowledge of insurance verification, billing practices, and reimbursement processes.
- Excellent communication and customer service skills.
- Proficiency in Microsoft Office and healthcare billing systems.
Preferred Qualifications (if any)
- Prior experience in a hospital or healthcare setting.
- Knowledge of Medicaid/Medicare and commercial insurance plans.
- Ability to handle complex patient financial cases with professionalism and empathy.
Certifications (if any)
- None required; certification in medical billing or patient financial services is a plus.