NOVUS HEALTH Patient Financial Services Representative Position Summary The PFSR provides administrative and financial support to healthcare operations by assisting patients, insurance companies, and internal departments with billing and account-related inquiries. This is accomplished by verifying patient demographics and insurance information, maintaining current consent forms, insurance verification, financial counseling, billing inquiries, and payment processing. This role serves as a liaison between patients, healthcare providers, insurance companies, and the billing team to ensure accurate demographic and financial information, promote access to care and facilitate a positive patient financial experience while ensuring excellent customer service and compliance with HIPAA regulations.
The PFSR assists patients in understanding insurance benefits and payment options while supporting revenue cycle operations and organizational financial goals. Essential Responsibilities Patient Financial Counseling - Educate patients regarding insurance benefits, financial responsibilities, copayments, deductibles, coinsurance, and out-of-pocket expenses.
- Provide estimates of patient financial responsibility when available and appropriate.
- Explain Novus Health financial policies and payment expectations.
- Assist patients in understanding billing statements and payment options.
- Support informed financial decision-making regarding healthcare services.
- Provide compassionate and professional financial guidance.
Insurance Verification & Eligibility - Verify patient insurance coverage, eligibility, and benefits prior to services.
- Review insurance information for accuracy and completeness.
- Identify coverage limitations, authorization requirements, and patient financial obligations.
- Communicate benefit information to patients and clinical staff.
- Update insurance information within the Electronic Health Record (EHR) and practice management systems.
- Resolve insurance discrepancies and coverage issues as appropriate.
Billing & Account Support - Respond to patient inquiries regarding billing statements, account balances, and payment arrangements.
- Investigate and resolve patient account issues and billing concerns.
- Coordinate with billing teams, insurance carriers, and providers to address account discrepancies.
- Assist with account reconciliation activities as assigned.
- Support timely resolution of outstanding patient balances.
- Maintain accurate documentation of financial communications and account activity.
Payment Collection & Processing - Collect copayments, deductibles, balances, and other patient payments in accordance with organizational policies.
- Process payments accurately and securely.
- Establish and manage payment plans when appropriate.
- Reconcile payment records and maintain transaction accuracy.
Financial Assistance & Resource Coordination - Screen patients for uninsured, self-pay, and sliding fee scales eligibility.
- Make the appropriate referral and coordinate with internal sources for obtaining insurance if appropriate
- Support organizational efforts to improve healthcare affordability and access.
Revenue Cycle Support - Support front-end revenue cycle activities related to patient registration and insurance verification.
- Follow up with insurance carriers regarding claim status and reimbursement
- Monitor accounts requiring patient follow-up and resolution.
- Support clean claim submission through accurate demographic and insurance information collection.
- Collaborate with billing and coding teams to resolve financial issues.
- Contribute to revenue cycle performance and financial sustainability initiatives.
Patient Experience & Customer Service - Deliver exceptional customer service during all patient interactions.
- Maintain professionalism and empathy when discussing sensitive financial matters.
- Address patient concerns promptly and respectfully.
- Promote positive patient experiences while balancing organizational financial responsibilities.
- Support patient retention and satisfaction initiatives.
- Foster trust and transparency in financial communications.
Documentation & Electronic Systems - Maintain accurate and timely documentation of financial interactions, payment arrangements, and account activities.
- Utilize Electronic Health Records (EHR), practice management systems, and billing software effectively.
- Ensure proper documentation of financial assistance activities and account resolutions.
- Generate reports and account summaries as assigned.
- Maintain copies of the front/back of all insurance cards, picture ID,
- Monitor and maintain current consent forms, self-pay authorization agreement, and sliding fee scale applications and associated documents, along with any documentation to support eligibility as needed.
- Perform general data entry and administrative support duties as requested
- Support audits and financial reviews through accurate recordkeeping.
Compliance & Regulatory Responsibilities - Maintain compliance with HIPAA and patient privacy regulations.
- Adhere to organizational financial policies and procedures.
- Follow applicable healthcare billing and insurance regulations.
- Protect confidential patient and financial information.
- Participate in compliance training and regulatory updates.
- Report suspected fraud, waste, abuse, or compliance concerns according to policy.
Required Qualifications: - High School Diploma/GED
- 1 year of medical insurance verification experience
- 5 years of customer service experience
Preferred Qualifications: - Experience with eClinicalWorks is a major plus
- 1 year of front desk experience
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