Job Description

The Patient Financial Specialist role is a blend of billing, claims follow-up, customer service, and payment posting. The Patient Financial Specialist plays a key part in ensuring that patients are billed correctly and that the organization is reimbursed accurately by insurance companies.

Responsibilities/Duties:

• Insurance Claims Processing
  • Submit and follow-up with third-party payors, resolve delays, and handle patient statements.
  • Maintain HIPAA compliance.
  • Ensure accuracy in billing functions.
  • Complete and submit claim forms for payment and statement charges per payer instructions.
  • Follow up on delayed claims.
  • Sort and distribute incoming Patient Business Services mail.
  • Organize, scan (if applicable), and file cash folders.
• Cash Handling
  • Accept and post payments received from patients in person, over the phone, and via CRM/online payments.
  • Receive and file approvals for payment; mail statements for balance of charges when applicable.
  • Serve as backup for Accounts Receivable:
    • Accept payments through mail and over the counter.
    • Post checks received.
    • Balance cash and daily receipts.
    • Create daily cash sheet and payment posting batches.
    • Prepare bank deposits.
  • Customer Service
    • Act as a compassionate, professional point of contact for patients, employers, and insurance providers regarding financial matters.
    • Treat each patient/guarantor as a valued customer.
    • Demonstrate empathy, courtesy, and professionalism in all interactions.
    • Maintain a positive and professional image.
  • General Support
    • Assist with mail, phone coverage, and support other roles during absences (e.g., PFS Specialist, Prior Authorization Credentialing Specialist).
    • Assist the switchboard in emergency situations by serving as a runner for Patient Access.

Education/Experience:

• Completion of high school diploma or equivalent.
• Ability to read, write, and communicate effectively in English.
• Prior experience with typing and computer use.
• Proficiency in Microsoft Office applications; ability to learn electronic billing software within 60 days of hire.
• Ability to work effectively in a fast-paced environment with frequent interruptions.
• Strong customer service skills and ability to remain calm in stressful situations.
• Excellent communication skills for explaining bills, insurance issues, and answering patient questions.
• Understanding of medical terminology and insurance guidelines/policies.
• Strong attention to detail and organizational skills; note-taking experience preferred.
• Experience in finance-related areas such as accounts receivable, patient billing, or insurance claims processing, preferred.

Professional Skills & Expectations:

• Takes responsibility for learning, applying, and modeling service standards in all encounters.
• Participates in service improvement training and activities.
• Helps others understand and apply service standards in customer interactions.
• Participates in special projects and/or committee work.
• Actively recognizes peers.
• Adheres to STAR Standards: Service, Teamwork, Accountability, Respect.
• Maintains confidentiality in compliance with state and federal law, including HIPAA.
• Complete annual in-service(s).
• Accountable for completion of training required for job description.
• Reliable in attendance and punctuality.
• Demonstrates safety practices in job performance.
• Demonstrates knowledge of compliance program/hotline.
• Resolves conflict productively by communicating with those involved and limiting discussion with those not involved.
• Refrains from gossip or negative commentary about customers.
• Supports organizational and departmental goals and performance improvement activities.
• Complies with all rule, regulations, laws, policies, procedures, and standards.
• Demonstrates respect for diverse cultural, religious, and philosophical values.
• Complies with Cell Phone policy.
• Complies with Computer Usage policy.
• Complies with Tamarack Health policies.