Patient Financial Services Cost of Care Representative

Generate estimates and analyze for accuracy, using the estimator tool with an understanding of managed care payment methodologies including, but not limited to, APC, DRG, per diem, fee schedules; adjusting data to re-calculate if necessary. Works directly with ancillary departments, contracting, government payment and pricing staff, insurance carriers, and other internal/external resources to provide patients with appropriate payment and pricing information.

Responsibilities/Job Description:

This position, under Revenue Cycle Management, is responsible for providing patients with timely and accurate pre-service pricing estimates with outstanding customer service. Works directly with ancillary departments, contracting, government payment and pricing staff, insurance carriers, and other internal/external resources to provide patients with appropriate payment and pricing information. Responsibilities include, but are not limited to, patient education, insurance verification, and excellent written and verbal communication.

 

Monday thru Friday / 7:30 am to 4:00 pm

Responsibilities

• Obtain required demographic, medical coding, and insurance information necessary for accurate estimate creation.
• Provide customer friendly education on requirements for calculating payment, pricing and scope of service that will be provided.
• Generate estimates and analyze for accuracy, using the estimator tool with an understanding of managed care payment methodologies including, but not limited to, APC, DRG, per diem, fee schedules; adjusting data to re-calculate if necessary.
• Provide a finalized estimate to customers, including a breakdown of benefits when the customer is insured.
• Offer pre-payment options to the customer when appropriate and processes payment collection.
• Respond to or escalate inquiries in a professional manner in the pursuit of timely resolution and minimum impact to the customer experience.

Required Qualifications

• 3 years customer service experience with 2 of those years in healthcare customer service.

Preferred Qualifications

• A.A./A.S. in business, healthcare, or related field
• 1 year experience providing cost of care information to customers
• Experience with Epic

 

Qualifications:

$22.96- $32.42 Hourly