Patient Collections Representative / Patients Financial Engagement Rep

Job Overview

The Patient Collection Specialist is responsible for addressing billing inquiries with professionalism, empathy, and accuracy. This involves listening attentively to patients, researching account details, and educating them on financial responsibilities to facilitate timely resolution. By maintaining patient confidentiality and clear documentation, this role actively supports HCM’s mission and values, promoting trust and positive relationships throughout the healthcare billing process.

Key Responsibilities

1. Patient Inquiry Management
2. • Respond to inbound and outbound calls, listening attentively to patient concerns.
   • Interpret Explanation of Benefits (EOBs) and insurance claims to clarify outstanding balances.
   • Process credit card and ACH payments, ensuring compliance with security protocols.
3. Billing & Account Resolution
4. • Research and resolve billing inquiries effectively, documenting actions taken for easy follow-up.
   • Verify insurance eligibility and manage coordination of benefits for patients with multiple insurers.
   • Articulate payment plans, financial assistance options, and write-off policies per client guidelines.
5. Customer Service & Escalations
6. • Engage patients with empathy, aiming to resolve issues at first contact.
   • Elevate concerns to supervisors or managers when necessary to expedite resolution.
   • Provide education on insurance terminology, coverage specifics, deductibles, copays, and patient responsibilities.
7. Compliance & Confidentiality
8. • Maintain strict adherence to HIPAA guidelines, safeguarding patient information.
   • Follow standard operating procedures (SOPs), guidelines, and policies when handling sensitive data.
   • Complete all documentation accurately to ensure traceability and compliance.
9. Operational Efficiency
10. • Utilize client EMR systems and billing platforms to track account statuses and update patient records.
    • Manage the status of accounts and identify inconsistencies or errors requiring additional attention.
    • Support teammates by sharing best practices and contributing to a team-oriented environment.

Key Performance Indicators (KPIs)

1. Customer Service
2. • Average Handle Time (AHT): Balance talk time, hold time, and after-call work to maintain efficiency.
   • Customer Effort Score (CES): Manage escalations effectively, tracking status to ensure timely resolutions.
3. Call Totals
4. • Track inbound & outbound call volumes, aiming to meet or exceed departmental metrics.

What We Offer

• Comprehensive Training: On-site and virtual training to help you master the nuances of healthcare billing.
• Flexible Scheduling: Core working hours are Monday–Friday, 7:30 a.m. to 6 p.m., with occasional weekend shifts as needed.
• Supportive Team Culture: Collaborative environment where knowledge-sharing and teamwork drive success.
• (Optional) Additional Benefits: If applicable, detail medical/dental/vision insurance, retirement plans, or tuition reimbursement here.

Minimum Qualifications

1. Schedule & Attendance
2. • Availability during designated working hours; regular and predictable attendance is essential.
   • Openness to occasional weekend work if business needs arise.
3. Technical Proficiency
4. • Intermediate computer skills, including Microsoft Office applications.
   • Ability to navigate multiple software systems (e.g., EMR platforms, billing software).
5. Communication & Customer Service Skills
6. • Exceptional verbal and written communication; strong phone contact handling skills.
   • Ability to multi-task, prioritize, and manage time effectively.
7. Problem-Solving & Critical Thinking
8. • Working math aptitude for handling payments, co-pays, and account reconciliations.
   • Strong analytical skills to identify and resolve inconsistencies or errors in billing.
9. Confidentiality & Professionalism
10. • Maintains strict patient confidentiality in accordance with HIPAA regulations.
    • Exhibits integrity, empathy, and a professional demeanor in all interactions.

Work Environment & Physical Demands

• Office Setting: Moderate noise level, primarily seated work, with occasional walking and reaching.
• Physical Requirements: Must be able to lift and/or move up to 10 pounds occasionally; close vision and ability to adjust focus are required for computer work.
• Reasonable accommodations can be provided to individuals with disabilities to perform essential functions.

Join Us

If you are passionate about delivering compassionate customer service and want to contribute to a patient-focused healthcare revenue cycle, we invite you to apply for the Patient Collection Representative position at HCM. attributes of the ideal candidate