Patient Financial Services Representative - Insurance Verification

Job Description:

The Care New England Patient Financial Services Representative (PFSR) is responsible for securing inpatient and outpatient visits.

The PFSR will complete all notifications, insurance verifications and authorizations activities.

The PFSR will ensure all necessary payers are aware of patient admissions, ensure that the patient’s insurance benefits are active and will cover the type and length of services provided by the applicable facility and or office.

Duties and Responsibilities:

Determination of patient’s copayment liability, any applicable co-insurance, deductibles and lifetime maximums.

The PFSR will perform the pre-authorization/pre-certification if required for the patient’s initial and any subsequent dates of services provided.

Track ongoing authorizations where applicable.

Performs calculations related to liabilities using technical resources.

Interacts with multiple third party payor online systems and or customer service department to secure benefits and authorizations.

Collaborates with team members across the CNE Revenue Cycle to secure benefits and authorizations.

Requirements:

High School Diploma required; Associates degree preferred or two years experience in a medical setting or equivalent combination of education and experience.

Knowledge of third party payers preferred.

Excellent typing skills and ability to operate standard office equipment necessary.

Excellent interpersonal and communications skills, knowledge of medical terminology, and computer applications required.

Schedule flexibility required to occasionally work additional, unscheduled hours.

Care New England Health System (CNE) and its member institutions; Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.