Patient Financial Representative

Summary

BayCare Health System is a healthcare network providing hospital, home health, outpatient, and physician services. The Patient Financial Representative II performs patient accounting functions focused on accounts receivable follow-up, insurance collections, claim resolution, denial management, and cash posting. The role also handles billing inquiries, payment posting, account documentation, payer communications, and reimbursement guideline compliance.

Responsibilities

• Performing a variety of patient accounting functions with a strong focus on accounts receivable follow-up, insurance collections, claim resolution, denial management, and cash posting activities
• Ensure timely reimbursement by reviewing outstanding accounts, resolving billing issues, and following up with insurance carriers and patients regarding claim status and outstanding balances
• Billing, collections, customer service, payment posting, and cash applications
• Documenting patient account activity
• Responding to customer billing inquiries
• Implementing billing guideline changes
• Identifying payer-specific trends
• Applying federal and state guidelines to collection efforts
• Interprets and follows up on Explanation of Benefits (EOBs)
• Reviews claims through payer portals
• Communicates with insurance providers and patients regarding billing and claims
• Researches and resolves denials
• Performs other duties as assigned

Skills

• High School Diploma or GED Equivalent required
• Required: 1 year of customer service experience
• None required
• Interpersonal skills
• Ability to communicate clearly
• Computer skills
• Organizational skills
• Professional etiquette, respect, and courtesy with others
• Customer service skills
• Administrative and clerical skills
• Organizational skills and attention to detail
• Knowledge of regulatory standards appropriate to the position
• Medical terminology knowledge and understanding
• Strong written and verbal communication skills
• Ability to work collaboratively within a team environment
• Computer skills appropriate to the position
• Experience with payer portals, insurance follow-up, claim resolution, denial management, EOB review, and cash posting
• Knowledge of Medicare, Medicaid, and commercial insurance reimbursement processes

Qualifications

Must Haves

• High School Diploma or GED Equivalent required
• Required: 1 year of customer service experience
• None required
• Interpersonal skills
• Ability to communicate clearly
• Computer skills
• Organizational skills
• Professional etiquette, respect, and courtesy with others

Nice to Haves

• Customer service skills
• Administrative and clerical skills
• Organizational skills and attention to detail
• Knowledge of regulatory standards appropriate to the position
• Medical terminology knowledge and understanding
• Strong written and verbal communication skills
• Ability to work collaboratively within a team environment
• Computer skills appropriate to the position
• Experience with payer portals, insurance follow-up, claim resolution, denial management, EOB review, and cash posting
• Knowledge of Medicare, Medicaid, and commercial insurance reimbursement processes

Benefits

• Medical, Dental, and Vision Benefits
• Paid Time Off (PTO)
• Tuition Assistance
• 401(k) Match and Additional Annual Employer Contribution
• Annual Performance Appraisals and Team Award Bonus Opportunities
• Family Resources and Wellness Programs
• Community Perks and Employee Discounts
• Career Growth and Development Opportunities
• The opportunity to be part of an amazing team and a great place to work
• Always working remotely