Patient Financial Services Rep

Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.

Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.

Summary:
The Patient Financial Services (PFS) representative will serve as a primary support to Steward Medical Group (SMG) patients regarding any concerns related to billing, self-pay balances, insurance payments, and all other financial matters. This position will also help in collection of patient payments, setting up payment agreements and assisting in portal services.

Responsibilities:
Provide patients with World Class service
Answer incoming patient phone calls and make outbound collection calls on open balances
Update patient insurance, confirming eligibility and queue claims for billing
Update demographic and guarantor information in the Patient Accounting System
Act in a professional manner and treat patients, co-workers, and leadership with respect at all times
Troubleshoot and identify patient billing issues to resolve them to patients satisfaction
Ability to explain and discuss SMG and PFS policies for better patient understanding
Educate patients about third party and insurance processes, their plan benefits, and how they affect patient balances
Evaluate accounts from both an insurance and self-pay perspective
Evaluate accounts for self-pay refunds
Manage and work queues and worklists in patient billing system
Advocate for patients and contact insurance companies on their behalf, when necessary, to resolve disputes
Assist with patients with access to the Patient Portal and password resets
Set up payment plans, monitor and make outbound calls to patients with broken promise to pay agreements
Ability to approach patient and discuss open, unpaid or overdue balances
Receive and process patient credit card payments, and allocate to appropriate visits on the account
Evaluate accounts for bad debt placement and wok with bad debt vendor on patient issues and concerns
Post appropriate discounts and adjustments to patient accounts
Interact with supporting departments; coding, cash-ops, AR follow up to resolve billing and payment issues
Interact with Practices to communicate and work cooperatively regarding patient billing issues
Maintain expected performance metrics
Other duties as assigned

Required Knowledge & Skills:
Knowledge of insurance rules/regulation and policies
Professional Working Revenue Cycle experience in either an AR follow up, Cash-Ops, denial management or self-pay role
Ability to bring tasks to completion in a manner satisfactory go all
Ability to communicate with others effectively in a concise manner, in order to bring issues effectively to a resolution
Ability to identify billing trends affecting patient balances
Ability to evaluate situations and escalate issues appropriately
Ability to multitask, and ability to follow through with our patients and contacts
Ability to read, understand and interpret insurance Explanation of Benefits
Prior experience with Athena preferred
Experience with Excel, Word and Outlook required
Organizational, time management skills
Ability to think globally about the patient experience

Education/Experience/Etc.:
Education: Associates degree or relevant work experience required
Experience (Type & Length): Medical billing, preferably in a professional setting, required
Certification/Licensure: N/A
Software/Hardware: Athena and Meditech experience preferred

Steward Health Care is an Equal Employment Opportunity (EEO) employer, Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Additional Information

Steward Medical Group is taking additional necessary preparations to ensure patients can receive compassionate care in safe, carefully managed environment with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience.
1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
2. A stringent cleaning policy has been implemented throughout our facilities.
3. A strictly controlled visitor and mask policy is required for patient and colleague safety.
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.

Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.