Sr Patient Finance Representative- Remote

This role collects, verifies, and updates patient demographic, insurance, referral, and authorization information while partnering with physician offices, clinical departments, insurance companies, and families to support a smooth patient experience. The Senior Patient Finance Representative helps identify coverage limitations, resolve issues impacting account resolution, and ensure compliance with payer requirements and hospital policies.

Position Summary
The Senior Patient Finance Representative is responsible for ensuring patients have accurate financial clearance prior to receiving care. This role collects, verifies, and updates patient demographic, insurance, referral, and authorization information while partnering with physician offices, clinical departments, insurance companies, and families to support a smooth patient experience. The Senior Patient Finance Representative helps identify coverage limitations, resolve issues impacting account resolution, and ensure compliance with payer requirements and hospital policies.
Key Responsibilities

• Manage daily assignments and work queues to ensure timely completion of financial clearance activities.
• Collect, verify, and update patient demographic and insurance information in accordance with hospital policies.
• Verify insurance eligibility through payer websites, available technology systems, and direct communication with insurance companies.
• Ensure accurate entry of insurance plans, filing order, and coverage details within the patient accounting system.
• Obtain and enter referrals from primary care physician offices as needed.
• Collaborate with clinical departments, case managers, and physician offices to obtain required insurance authorizations.
• Communicate with patients and families regarding insurance coverage limitations and potential financial responsibilities.
• Assist with authorization denials, including coordinating peer-to-peer reviews when needed.
• Document account activity clearly and accurately.
• Identify trends, issues, and opportunities for process improvements related to financial clearance and account resolution.
• Provide excellent customer service and demonstrate empathy when supporting patients and families.

Minimum Qualifications
Education:

• High School Diploma or GED required.

Experience:

• Minimum of 1 year of direct experience working with health insurance, referrals, and authorizations required.
• Experience with patient financial services, insurance verification, or healthcare revenue cycle preferred.
• Familiarity with medical terminology and healthcare systems preferred.

Schedule:

• Full-time - remote