Patient Financial Services Representative (Insurance Verification)
Care New England Health System - Finance Administration Job ID: 08223-80738-006
The Patient Financial Services Representative (PFSR) is responsible for securing inpatient and outpatient visits. The PFSR will complete all notifications, insurance verifications and authorizations activities. The PFSR will ensure all necessary payers are aware of patient admissions, ensure that the patient’s insurance benefits are active and will cover the type and length of services provided by the applicable facility and or office. Responsibilities include determination of patient’s copayment liability, any applicable co-insurance, deductibles and lifetime maximums. The PFSR will perform the pre-authorization/pre-certification if required for the patient’s initial and any subsequent dates of services provided. Track ongoing authorizations where applicable. Performs calculations related to liabilities using technical resources. Interacts with multiple third party payor online systems and or customer service department to secure benefits and authorizations. Collaborates with team members across the CNE Revenue Cycle to secure benefits and authorizations.
High School Diploma required; Associates degree preferred or two years experience in a medical setting or equivalent combination of education and experience. Knowledge of third party payers preferred. Excellent typing skills and ability to operate standard office equipment necessary. Excellent interpersonal and communications skills, knowledge of medical terminology, and computer applications required. Schedule flexibility required to occasionally work additional, unscheduled hours.