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The Patient Financial Representative performs the functions of Patient Account Management for individuals receiving care from the University of Rochester Medical Center (URMC), Highland Hospital (HH), and University of Rochester Medical Facility Group (URMFG). The Patient Financial Representative responds to patients’ inquiries via telephone, MyChart, mail, email, and fax, concerning, but not limited to, billing issues, claim payments, contract benefits, and medical billing in accordance with HIPAA, Third Party Billing rules and regulations, and the Fair Credit Debt Collection Practices Act. The Patient Financial Representative acts with compassion and empathy, exercises tact, patience, and professionalism at all times in responding to internal/external customers. Acts as a liaison among the customers, business partners, and plans in a professional, self-directed manner to ensure and promote customer satisfaction and retention.
Job Responsibility:
Researches, interprets and responds to inquiries from internal and external customers concerning unresolved patient billing issues, outstanding balances as a result of statements sent within the billing systems (EPIC, Flowcast, and HBOC) utilizing reference materials and available resources
Resolves customer inquiries in an accurate, organized, efficient, timely, and expert manner, resulting in acceptable accuracy, production levels, and retention of patient services
Consistently adheres to all Patient Service policies, procedures, and performance measures including inquiry documentation procedures
Maintains performance and quality standards based on established call center metrics including turn-around times
Initiates insurance billing either electronically or via the use of the Electronic Work file transfer process within the billing systems for accounts classified as Self-Pay in error
Identifies and verifies coverage under the government health insurance programs
Secures revenue for URMC, HH, and URMFG by advising customers about insurance and payment options
Creates budget installment payment plans for those customers in need
Identifies patterns generated by external and internal activity impacting customer satisfaction
Uses best judgment under set procedures, alert management regarding issues not completed within specified timeframes
Participates in training to learn regulations, systems, procedures, develop skills and initiate actions to accurately fulfill all requirements of the job
Safeguards member privacy in accordance with the corporate privacy policies and procedures
Performs other related duties as assigned
Requirements:
Associate's degree and 2 years of relevant experience required
Equivalent combination of education and experience
Proven and effective diplomatic communicator demonstrated by the ability to consistently present and express oral and written information in an organized, understandable, complete, and concise manner
Strong organizational skills, reasoning, and problem-solving skills
Ability to multi-task in order to efficiently resolve customer concerns, by actively listening to the customer, navigating multiple programs and applications at the same time, typing call documentation, and speaking to the customer simultaneously
Ability to prioritize tasks and work in fast paced environment
Ability to work effectively as a member of a team
Excellent computer skills
Proficient at instant messaging and text messaging technology
Consistently demonstrate high standards of integrity by supporting the URMC’s values, and adhering to the Corporate Code of Conduct, and ICARE Philosophy of Care
Ability to remain professional and focused under multiple pressures and demands
Actively participate in and contribute to the daily operations of the Patient Services Department by identifying improvements to processes, services, and the patient experience