Patient Financial Service Representative

About the Role

The Patient Financial Services Representative (PFSR) is the first point of contact for patients and guarantors in hospital, ambulatory, or medical office settings. The PFSR gathers and verifies demographic, financial, and insurance eligibility information, and ensures all required notices and consent forms are signed.

Key Responsibilities

• Provides exceptional customer service, addressing questions and concerns in a timely and courteous manner.
• Guides patients to appropriate destinations for services.
• Obtains pre-certification and authorization.
• Verifies insurance benefits, including obtaining insurance cards and confirming coverage is active.
• Determines the correct insurance filing order if multiple insurances are effective.
• Explains policies, including all regulatory and financial consent forms, and secures required signatures.
• May perform patient discharge functions, including reviewing the After Visit Summary (AVS), scheduling future appointments, and handling referrals.
• Interviews patients and guarantors to obtain necessary information, including a copy of identification.
• May confirm physician and prescription orders for accuracy.
• May schedule walk-in appointments for offered services.
• Collects patient out-of-pocket responsibility per collection guidelines.
• Provides patient estimates as requested.
• Prepares and balances a daily deposit of all payment collections.

Responsibilities in Memorial Physician Group (Specialty Practices)

• Obtain specialty authorizations.
• Manage authorization denial and peer-to-peer processes.
• Provide patient care navigation (e.g., surgical and procedural coordination and scheduling).
• Handle all incoming calls and physician and hospital back lines.
• Obtain and confirm referrals.

Responsibilities in the Hospital

• Upon validation of patient identity, place identification band on patient.
• Obtain signatures for hospital-specific regulatory forms.
• Obtain authorizations for walk-in appointments.
• Determine when financial assistance is needed.

Responsibilities in Memorial Primary Care

• Manage MIH-MPC program patient referral, payment collection, and eligibility scheduling.
• Process referral work-ques and same-day access requests.
• Collaborate with the Patient Access Center on real-time patient requests.
• Address prescription refill requests, patient advice requests through MyChart, and provider scheduling templates.

Requirements & Tech Stack

• High School Diploma or Equivalent (Required)
• Excellent communication skills
• Critical thinking skills
• Decisive judgment
• Ability to work with minimal supervision
• Ability to work in a stressful environment and take appropriate action
• Ability to work and build relationships collaboratively
• Keyboard Entry (100%)
• Repetitive Movement Hand/Arm (80%)
• Sitting (80%)
• Standing (80%)
• Walking (80%)
• Audible Speech (80%)
• Hearing Acuity (80%)
• Depth Perception (80%)
• Seeing - Far (80%)
• Seeing - Near (80%)
• Computer Monitor (100%)

Qualifications

• Accountability
• Accuracy & Quality
• Customer Service
• Organization Skills
• Problem Solving
• Productivity
• Responding to Change
• Standards of Behavior