Job Title : Patient Financial SpecialistJob Summary : The Patient Financial Specialist is responsible for providing support to High Performance Work Teams by ensuring timely and efficient processes.

Duties include cash posting, customer service, data entry, and reviewing claims for proper billing and collections. This role also involves performing billing, collections, and reimbursement services for claims related to hospitals supported by the organization, ensuring compliance with government-mandated procedures.

The Specialist must maintain professionalism while assisting patients, physician offices, insurance companies, and other clients, handling documentation, correspondence, and confidentiality with utmost care.

Major Job Responsibilities : Meet daily productivity standards and clear daily EOBs, reports, and appeal files within 48 hours of receipt.

Maintain knowledge of Governmental Mandated Regulations related to claims submission and perform necessary research before claims submission.

Collaborate with Clinical departments and Medical Records to resolve erred claims and integrity issues.Review and resolve suspended claims daily in electronic billing terminals, ensuring compliance with procedures.

Work on claims generated reports, provide proper documentation, and make necessary corrections within specified timelines.

Handle business service requests and document them within 24 hours of receipt.Identify and forward proper account denial information to designated departmental liaison, dedicating efforts to ensure proper denial resolution.

Monitor and communicate errors generated by other departments, highlighting trends.Stay updated on all billing and reimbursement requirements by Payer, ensuring compliance with government changes and providing continuous updates to Business Office Management regarding ongoing errors and related issues.

Job Standard Qualifications : High School Diploma or equivalent.

Last updated : 2024-05-17