Patient Financial Services Associate

Who we are:

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most - patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.

What you'll do:

The Patient Financial Services (PFS) Representative is responsible for providing accurate, timely, and courteous financial services to patients throughout the revenue cycle. This role supports front‑end and post‑service financial processes including insurance verification, benefit interpretation, patient billing inquiries, collections, and payment resolution while ensuring compliance with organizational policies and regulatory requirements.

Responsibilities/Duties:

• Serve as a primary point of contact for patient financial inquiries via phone, portal, or written correspondence.

• Explain insurance benefits, coverage limitations, patient responsibility, and payment options in a clear, professional manner.

• Provide cost estimates and financial counseling as appropriate.

• Provide daily guidance, coaching, and support to Patient Financial Services Representatives

• Serve as the first level of escalation for complex patient, billing, or account issues

• Verify insurance eligibility and benefits and document findings accurately in the system.

• Review patient accounts for accuracy, including demographic, coverage, and billing information.

• Submit, review, and follow up on insurance claims and patient balances as assigned.

• Identify and resolve billing discrepancies, underpayments, or denials within defined workflows.

• Support staff in explaining insurance benefits, patient responsibility, payment plans, and financial assistance options

• Collect patient payments and establish payment plans per organizational policy.

• Post payments and adjustments accurately when assigned.

• Ensure compliance with HIPAA and all applicable state and federal regulations.

• Maintain confidentiality of all patient and financial information.

• Follow departmental policies, procedures, and documentation standards.

• Other duties as assigned