Patient Financial Specialist

Essential Job Functions

• Conduct comprehensive patient intake by collecting demographic, contact, and insurance information.

• Execute precise data entry into the Electronic Health Record (EHR) system to ensure seamless downstream billing.

• Verify active Medicaid coverage and benefits through state portals and real-time eligibility tools.

• Act as a patient advocate by assisting with Medicaid enrollment, renewals, and the gathering of required documentation (e.g., ID, income verification, and residency proof).

• Determine Coordination of Benefits (COB) to identify whether Medicaid is the primary or secondary payer.

• Partner with third-party payers to resolve coverage discrepancies.

• Provide empathetic, clear explanations regarding Medicaid benefits, eligibility requirements, and billing inquiries.

• Utilize active listening and probing questions to identify and resolve patient financial concerns.

• Maintain meticulous patient records in strict accordance with HIPAA, HITECH, and JCAHO regulations.

• Safeguard corporate and client assets by following all organizational security policies.

   

Key Success Indicators/Attributes

• Ability to prioritize and multi-task in a fast-paced, changing environment.

• Demonstrate ability to self-motivate, set goals, and meet deadlines.

• Demonstrate excellent verbal communication skills, with the ability to effectively explain complex billing and insurance concepts to patients.

• Strong active listening skills to understand patient concerns and provide appropriate resolutions.

• Maintain courteous and professional working relationships with employees at all levels of the organization.

• Work in accordance with corporate and organizational security policies and procedures, understand personal role in safeguarding corporate and client assets, and take appropriate action to prevent and report any compromises of security within scope of position.

• Compassionate and empathetic personality to handle patient inquiries and concerns with sensitivity and professionalism.

• Skill in operating a personal computer and utilizing a variety of software applications is essential.

• Understanding of HIPAA and basic reimbursement principles.

• Ability to work across multiple systems (EMR, PMS, digital portals).

Supervisory Responsibility

No

Work Environment

This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and soft phones.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work

This is a full-time position.  Each employee’s schedule must be between the hours of 6:00 AM PST to 9 PM PST, Monday through Friday, with the specific schedule for each employee to be agreed upon by the employee’s manager and the employee, taking into account the needs of the client. This position occasionally requires long hours and weekend work. 

Travel

None

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.  Duties, responsibilities, and activities may change at any time with or without notice. Employee may perform other duties as assigned.

Qualifications