Job Description
Summary/Objective
Under supervision, the Patient Financial Support Representative will be responsible for completing patient enrollment and financial assistance activities using standardized OPM workflows. This role focuses on accurate patient enrollment in AssistPoint (AP), verification of patient and insurance information, processing of assistance program applications, and timely task completion based on defined plan expiration guidelines. The representative will ensure all assigned tasks are completed accurately, documented appropriately, and closed in accordance with program status, quality, and productivity standards.
Essential Job Functions
- Complete patient enrollment in AssistPoint (AP) for all assigned tasks.
- Follow two defined enrollment workflows:
- - Automatic Enrollment: Update payer information only in the Practice Management System (PMS).
- - Manual Enrollment: Complete enrollment activities in accordance with IPA process guidelines.
- Ensure enrollment activities are completed based on defined plan expiration dates and practice guidelines.
- Manage assigned inventory sourced from the Admin Portal.
- Verify and update patient demographics, insurance information, diagnosis, regimen, provider, and location details using EMR and Practice Management systems.
- Collect, review, and verify insurance information, income documentation, and eligibility criteria required for financial assistance or support programs.
- Process assistance program applications through digital enrollment platforms, web portals, or manual submission methods, including fax.
- Track application status and perform timely follow-up with patients and assistance organizations as needed.
- Maintain accurate documentation and backend logs for all completed enrollment and assistance activities.
- Close tasks in accordance with program status and established criteria, including scenarios such as funding exhaustion or program exclusions.
- Ensure all work is performed in compliance with company policies, HIPAA requirements, and applicable regulatory standards.
- Perform additional duties as assigned.
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
Required Education and Experience
- Minimum of 1-2 years prior experience/knowledge of patient billing or medical reimbursement processes, and insurance terminology.
- Proficient computer skills and experience with electronic health records (EHR/EMR) or billing software systems.
- High School diploma or equivalent, additional education in healthcare administration or related field is a plus.
- Proven experience in a customer service or call center role, preferably within the healthcare industry.
