JOB SUMMARY

The Patient Financial Specialist plays a vital role in ensuring accurate billing and reimbursement processes within the healthcare setting. This position requires a strong understanding of insurance policies and procedures to facilitate seamless claims processing.

EXPERIENCE

• Proficiency in HIPAA regulations and compliance
• Knowledge of medical terminology, ICD-10 coding, and medical coding practices
• Experience working in a medical office setting
• Familiarity with insurance verification processes
• Understanding of managed care plans and their requirements
• Strong attention to detail and accuracy in data entry
• Excellent communication skills for interacting with patients and insurance providers

• Verify patient insurance coverage and eligibility
• Submit prior authorizations to ensure approval and reimbursement of services
• Maintain up-to-date knowledge of insurance regulations and guidelines
• Collaborate with staff to ensure proper coding of services
• Update and maintain patient records with accurate insurance information
• Assist patients with insurance-related inquiries and provide clear explanations
• Conduct financial consultations with patients to review costs that are patient responsibility