Job Description

Location: Steward Medical Group - North
Posted Date: 4/7/2023

The Patient Financial Services (PFS) representative will serve as a primary support to Steward Medical Group (SMG) patients regarding any concerns related to billing, self-pay balances, insurance payments, and all other financial matters. This position will also help in collection of patient payments, setting up payment agreements and assisting in portal services.

KEY RESPONSIBILITIES:

(Use bullets for specific responsibilities)

  • Provide patients with World Class service
  • Act as subject matter expert and “go to” person regarding systems, policies and work flows
  • Will monitor and assist to reassign some staff duties as necessary based on inbound call volumes and other work load volumes
  • Monitor staff performance metrics for QA based on established standards for the department
  • Answer incoming patient phone calls and make outbound collection calls on open balances
  • Update patient insurance, confirming eligibility and queue claims for billing
  • Update demographic and guarantor information in the Patient Accounting System
  • Act in a professional manner and treat patients, co-workers, and leadership with respect at all times
  • Troubleshoot and identify patient billing issues to resolve them to patient’s satisfaction
  • Ability to explain and discuss SMG and PFS policies for better patient understanding
  • Educate patients about third party and insurance processes, their plan benefits, and how they affect patient balances
  • Evaluate accounts from both an insurance and self-pay perspective
  • Evaluate accounts for self-pay refunds
  • Manage and work queues and worklists in patient billing system
  • Advocate for patients and contact insurance companies on their behalf, when necessary, to resolve disputes
  • Assist with patients with access to the Patient Portal and password resets
  • Set up payment plans, monitor and make outbound calls to patients with broken promise to pay agreements
  • Ability to approach patient and discuss open, unpaid or overdue balances
  • Receive and process patient credit card payments, and allocate to appropriate visits on the account
  • Evaluate accounts for bad debt placement and work with bad debt vendor on patient issues and concerns
  • Post appropriate discounts and adjustments to patient accounts
  • Interact with supporting departments; coding, cash-ops, AR follow up to resolve billing and payment issues
  • Interact with Practices to communicate and work cooperatively regarding patient billing issues
  • Maintain expected performance metrics
  • Other duties as assigned

REQUIRED KNOWLEDGE & SKILLS:

(Examples: Ability to work independently and take initiative; Good judgment and problem solving skills; Communication skills; Interpersonal and organizational skills; Level of confidentiality)

  • Knowledge of insurance rules/regulation and policies
  • Professional Working Revenue Cycle experience in either an AR follow up, Cash-Ops, denial management or self-pay role
  • Ability to bring tasks to completion in a manner satisfactory to all
  • Ability to communicate with others effectively in a concise manner, in order to bring issues effectively to a resolution
  • Ability to identify billing trends affecting patient balances
  • Ability to evaluate situations and escalate issues appropriately
  • Ability to multitask, and ability to follow through with our patients and contacts
  • Ability to read, understand and interpret insurance Explanation of Benefits
  • Prior experience with Athena preferred
  • Experience with Excel, Word and Outlook required
  • Organizational, time management skills
  • Ability to think globally about the patient experience

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

Education: Associates degree or relevant work experience required

Experience (Type & Length): Medical billing, preferably in a professional setting, required

Certification/Licensure: N/A

Software/Hardware: Athena and Meditech experience preferred

Other: Proven past leadership/supervisory role in a healthcare setting


Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Application Instructions

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