Patient Financial Services Representative

Title: Patient Financial Services Representative

Location: United States

Remote

Job Description:

We are seeking an experienced Patient Financial Services Representative to join a health system in a fully remote capacity. This is a contract-to-hire opportunity, offering the potential for long-term employment with the organization. Candidates must have at least 2 years of experience in a similar patient access, patient financial services, billing, collections, or revenue cycle role supporting a health system, hospital, or a third-party company serving healthcare organizations, along with required UB-04 billing experience. Even though the role is fully remote, candidates need to be within driving distance of Memphis for ocassional in-office meetings that could be 1 - 2 times/year. Pay is $18-$20/hr, with potential for higher compensation based on relevant experience and qualifications.

Job Description

The Patient Financial Services Representative performs billing, collections, and reimbursement services within a healthcare setting, ensuring accurate claim submission and timely resolution of patient accounts. This role secures complete financial and demographic information, interprets complex insurance and contractual arrangements, and delivers courteous and professional customer service to patients, payers, and internal departments. The position supports the full revenue cycle by reviewing payments, identifying and correcting billing errors, and maintaining compliance with governmental and payer-specific regulations.

Responsibilities

• Manage billing, collections, reimbursement, and account resolution for assigned patient accounts while maintaining accurate records.
• Verify and document required financial and demographic information prior to claim submission.
• Review, research, and follow up on accounts to ensure accurate account information and timely reimbursement.
• Provide professional customer service to patients, payers, and internal stakeholders.
• Identify, correct, and resolve claim errors, denials, and billing discrepancies according to payer guidelines and billing procedures.
• Respond to patient and insurance inquiries by researching and resolving billing-related issues.
• Collaborate with clinical departments and Health Information Management (HIM) to ensure claim accuracy and resolve claim issues.
• Communicate recurring billing, reimbursement, registration, and payer issues to leadership.
• Maintain knowledge of payer requirements, billing regulations, reimbursement methodologies, and governmental compliance standards.
• Implement and comply with regulatory billing changes, including Medicare and other governmental updates.
• Research payer and governmental requirements to ensure compliant claim submission.
• Collect third-party payer balances in accordance with applicable laws and regulations.
• Review payments for accuracy against contracts, fee schedules, and reimbursement methodologies.
• Manage claim appeals and denials by identifying root causes and pursuing resolution.
• Utilize patient accounting systems to track, manage, and resolve accounts efficiently.

Essential Skills

• Minimum of two (2) years of experience in general hospital accounts receivable or hospital facility reimbursement.
• Experience working with UB-04 claim forms and the ability to accurately complete and interpret these forms.
• Ability to interpret Explanation of Benefits (EOB) forms and apply the information to patient accounts and claims resolution.
• Strong understanding of provider contractual language and the ability to apply contractual terms to real claims.
• Knowledge of different payment methodologies for both inpatient and outpatient services and how to apply these methodologies to claims and reimbursements.
• Experience working claim denials, including reviewing payments to ensure alignment with contracts and fee schedules.
• Experience working within a patient accounting system for managing and resolving accounts.
• Proficiency in patient access processes and insurance billing, including healthcare claims and reimbursement.
• High school diploma or equivalent.

Additional Skills & Qualifications

• College education is preferred and supports advancement within revenue cycle and patient financial services roles.
• Experience with revenue cycle management processes, including billing, collections, and reimbursement activities.
• Familiarity with insurance claims, insurance billing, and healthcare claims workflows.
• Ability to interpret and work with UB-04 claim forms, EOBs, and payer-specific guidelines.
• Strong analytical and problem-solving skills for identifying billing errors, resolving claim issues, and ensuring accurate payments.
• Effective communication skills for interacting with patients, payers, clinical departments, and administrative teams.
• Ability to stay current with evolving governmental regulations and payer billing requirements.

Job Type & Location

This is a Contract to Hire position based out of Memphis, TN.

Pay and Benefits

The pay range for this position is $18.00 - $20.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)