Patient Financial Specialist WPRC
Patient Financial Specialist WPRC
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Job Description
Overview of the Role:
The Patient Financial Specialist (PFS) is responsible for all communications with the patients regarding their insurance and/or account with Privia Medical Group as well as all communications with third party payers regarding benefits and/or payment of services. They are responsible for performing any or all of the below mentioned duties as necessary based on the responsible parties involved.
Essential Job Duties:
Contact the patient prior to the visit to obtain/update the patients demographic and insurance information. Enters/updates this information in POLCI.
Contact the third party payer as needed to obtain required information pertaining to the patients coverage for that visit.
Obtain physician referral prior for office visit/procedure.
Obtain all necessary verifications and referrals for Surgery accounts. Collect deposits deductibles and/or copays prior to their surgery.
Complete router with all pertinent information. This information should include but is not limited to the name of the third party payer the type of coverage (HMO PPO POS etc. method of payment copay or outofpocket deductibles.
Enter all information in the POLCI system insurance notes and when pertinent denotes the Primary Care Physician and whether a referral is needed.
Responds to patients requests regarding their account and explain Complete MD Solutions financial policy and procedures as needed.
Work with patients to secure prepayment sources or make other financial agreements prior to service/procedures.
Process billing calls and questions and answers correspondence related to patient accounts.
Assist in processing of insurance claims and resolving any coding or billing errors in order to maximize reimbursements and minimize patient liability.
Assist patients in completing all necessary forms and/or supply medical documentation as necessary.
Participate with other staff to seek account resolutions.
Follow up on unpaid claims and resubmits.
Follow up with third party payers regarding claims concerning nonpayments reductions down coding etc. and process appeals as necessary.
Audit all patient account transactions for accuracy and resolve any outstanding issues. Identify and correct billing errors.
Communicates with clinical hospital and physician personnel related to patient accounts and serves as primary problem solver.
Initiate requests for patient payments by telephone or letter or use of collection letters.
Audit all patient credit balance accounts for resolution. Make all refunds promptly.
Make recommendations concerning accounts to be written off and/or turned over for collection.
Post all actions related to the patients account into the computer system as a permanent record.
Request specific nongenerated routers through the Router Control Support Clerk.
Print Daily Activity Report at close of day to ensure charge/payment reentry activities are balanced.
Substitute for other PSRs as needed.
Participate in educational and developmental activities.
Attend meetings as requested.
Perform other duties as directed by the supervisor.
Qualifications :
Minimum Qualifications:
4 years of Appointment Secretary experience preferably in a OB/GYN medical office setting
2 years of PBX or call center experience
2 years of Athena EMR experience (Preferred)
Basic computer literacy
Ability to handle yourself in a professional manner
Ability to accurately enter patient data into office software
Be a selfmotivator and problem solver
Minimum Qualifications:
2 years of comprehensive experience in a medical/physician office environment.
2 years of medical collections experience.
1 year of working knowledge of CPT and ICD10 coding standards.
Athena EMR experience is preferred.
Education/Certificate/License
High School Graduate or GED
Physical Demands
Requires sitting for long periods of time working in an office environment with some bending and stretching. Working under stress and prolonged use of telephone required. Manual dexterity required for use of calculator and computer.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
#LIDNI
Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.
Remote Work :
No
Employment Type :
Parttime
Employment Type
Part-time
