Patient Financial Services Representative

 

Position Summary
The Patient Financial Services Representative supports hospital revenue cycle operations by 
performing patient billing, cashier activities, and financial counseling activities. This role ensures 
timely and accurate reimbursement for hospital services while providing a positive, patient centered financial experience.
The representative works closely with patients, clinical departments, and payers to support 
Medicaid eligibility, billing, and financial assistance programs, helping ensure access to care for 
diverse and underserved patient populations.

 

Key Responsibilities
Hospital Revenue Cycle Operations
• Perform payment posting, adjustments, and account reconciliation 
• Monitor assigned hospital accounts receivable and follow up on unpaid or underpaid 
claims 
• Investigate and resolve claim denials, coding issues, and billing discrepancies 
• Ensure timely account resolution in accordance with hospital billing guidelines 

 

Medicaid & Insurance Support
• Verify insurance coverage and Medicaid eligibility for hospital patients 
• Assist with Medicaid enrollment, applications, and redeterminations for admitted and 
outpatient patients 
• Submit and track Medicaid and third-party claims, including corrections and appeals 
• Identify denial trends and escalate issues impacting reimbursement 

 

Patient Financial Counseling
• Explain hospital billing processes, insurance coverage, and patient financial 
responsibility 
• Assist patients in applying for charity care, financial assistance, and presumptive 
eligibility programs 
• Collect required documentation and ensure completeness of applications 
• Set up payment plans in accordance with hospital policies 

 

Customer Service
• Respond to patient and guarantor inquiries regarding hospital bills and insurance claims 
• Provide clear, compassionate communication, especially in high-stress hospital situations 
• Resolve routine issues and escalate complex cases to supervisors 

 

Compliance & Documentation
• Maintain compliance with hospital policies, HIPAA, and federal/state regulations 
• Ensure accurate and complete documentation in hospital billing systems 
• Support audit activities by maintaining proper records and following internal controls 

 

Collaboration
• Coordinate with all registration areas
• Communicate with insurance companies and Medicaid representatives to resolve account 
issues 
• Support discharge planning by addressing financial clearance and eligibility needs 

 

 

Education
• High school diploma or equivalent required 
• Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field 
preferred 
Experience
• 1–3 years of experience in hospital patient financial services, billing, or revenue cycle 
operations 
• Familiarity with Medicaid eligibility and hospital-based financial assistance programs 
Skills
• Knowledge of hospital billing systems and electronic health records (EHR) 
• Strong understanding of insurance processes, including Medicaid and Medicare 
• Excellent customer service and communication skills in a healthcare environment 
• Ability to manage multiple accounts and meet productivity standards 
• Attention to detail, accuracy, and problem-solving abilities 
• Ability to work in a fast-paced hospital setting