MISSION

The Patient Financial Representative is responsible for serving as primary contact to educate patients and community about financial assistance and charity care programs, healthcare insurance exchange, or alternate insurance programs as appropriate, and providing price estimates.

OUTCOMES

• Interviews patients and/or family members to secure information concerning insurance coverage, eligibility, and qualification for various financial assistance programs and/or arranges payment plans, while potentially navigating difficult and sensitive conversations effectively.
• Maintains tracking, rescheduling, and cancelling of patients on schedule, ensuring that eligibility and authorization information has been entered into data entry systems timely and accurately, while efficiently notating secure notes.
• Acts as a liaison between clinical staff, patients, physician, and insurance payor by informing patients of authorization/benefit delays/denials, answering questions, educating patients about their benefit, offering assistance, and relaying messages pertaining to authorization or benefits of procedure/service.
• Calculate estimated patient responsibility to inform the patient and document in the data entry system and adhere to the Collections Policy to ensure patients are aware that payment is due at time of service
• Provide exceptional high quality care to patients and their families with respect and dignity while providing feelings of safety and security.
• Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification process.

COMPETENCIES

Job Related Competencies:

• Manages Conflict: Handling conflict situations effectively, with a minimum of noise lens

• Action Oriented: Taking on new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.

• Financial Acumen: Interpreting and applying understanding of key financial indicators to make better business decisions.

• Interpersonal Savvy: Relating openly and comfortably with diverse groups of people.

• Drive Results: Consistently achieving result, even under tough circumstances.

• People
  • Collaborates: Building partnerships and working collaboratively with others to meet shared objectives

• Heart
  • Patient Focus: Building strong patient relationships and delivering patient centric solutions

• Service
  • Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity

• Excellence
  • Cultivates Innovation: Creating new and better ways for the organization to be successful

• Being Resilient:
  • Rebounding from setback and adversity when facing difficult situations

• Self-Development:
  • Actively seeking new ways to grow and be challenged using both formal and informal development challenges

• Optimizes Work Processes:
  • Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement.

• Professional Communication:
  • Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone