Patient Financial Services Representative

Job description

Join the Team at Decatur County Memorial Hospital
At Decatur County Memorial Hospital (DCMH), we are more than a healthcare provider—we are a trusted community partner committed to improving the health and well-being of the individuals and families we serve. As a critical access hospital, DCMH combines high-quality patient care, advanced medical services, and a compassionate, patient-centered approach in a welcoming rural healthcare environment.
Our team is made up of dedicated professionals who are passionate about making a difference every day. We foster a culture of collaboration, respect, integrity, and continuous improvement, where employees are empowered to grow professionally while contributing to exceptional patient outcomes. DCMH offers competitive compensation and benefits, opportunities for professional development, and a supportive workplace that values each team member's contributions.
DCMH offers more than just a job—we offer a rewarding career and a supportive workplace culture. Employees enjoy competitive pay, comprehensive health and wellness benefits, generous paid time off, retirement savings opportunities, professional development support, and a variety of additional benefits designed to help you achieve your personal and professional goals. We are committed to creating an environment where team members feel valued, supported, and empowered to grow.
If you are seeking a rewarding career with an organization that is committed to excellence, innovation, and service, we invite you to explore opportunities with Decatur County Memorial Hospital and become part of a team that is making a meaningful impact in our community.
POSITION SUMMARY
• Reports To:
• Director, Patient Financial Services
• Summary:
• The Patient Financial Services Representative is responsible for the accurate and timely billing, follow-up, and resolution of patient accounts with assigned insurance payers until financial responsibility is transferred to the patient. This position ensures compliance with payer requirements, federal and state regulations, organizational policies, and HIPAA standards while utilizing electronic billing systems to maximize reimbursement and maintain accurate patient account records. The Patient Financial Services Representative provides exceptional customer service to patients, payers, and internal departments while supporting continuous improvement and regulatory compliance initiatives.
• Work Schedule:
• Full-time days, Monday through Friday Work schedule may be adjusted as needed to meet operational and business requirements.

SKILLS & ABILITIES
• Education
• High school diploma or equivalent required. Associate degree in Healthcare Administration, Business, Accounting, or related field preferred.
• Experience
• Minimum of one (1) year of medical billing, healthcare revenue cycle, accounts receivable, or related healthcare financial experience preferred Experience working with commercial insurance, Medicare, Medicaid, and government payer billing preferred Experience processing appeals, denials, and claim follow-up activities preferred
• Computer Skills
• Proficient in Microsoft Office, email, and other standard computer applications, with the ability to learn and effectively use software systems required for assigned responsibilities. Proficiency with electronic health record (EHR) and billing systems. Ability to navigate payer websites, clearinghouses, and online claim management tools. Accurate data entry and keyboarding skills.
• Certificates & Licenses
• Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) preferred
• Other Requirements
• Thorough knowledge of medical billing practices, insurance regulations, and payer requirements.
• Understanding of HIPAA privacy and security regulations.
• Ability to analyze and resolve billing discrepancies and account issues.
• Strong attention to detail, accuracy, and organizational skills.
• Excellent verbal and written communications skills.
• Ability to handle difficult conversations and interact professionally with upset or frustrated patients.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
• Commitment to customer service, teamwork, compliance, and continuous improvement.
• Ability to remain seated for extended periods while performing computer-based work.
• Essential Functions
• Process and submit primary and secondary insurance claims accurately and timely in accordance with payer requirements, contractual agreements, and organizational procedures.
• Rebill and follow up on unpaid, underpaid, denied, or rejected claims to ensure appropriate reimbursement.
• Investigate claim rejections and denials, identify root causes, and take corrective action to resolve billing issues.
• Prepare, complete, and submit required federal, state, and payer-specific forms, appeals, and supporting documentation.
• Utilize electronic billing, clearinghouse, and payer portal systems to monitor claim status and expedite payment processing.
• Ensure accurate payment posting, contractual adjustments, and account updates according to established procedures.
• Verify account balances, insurance coverage, and payer requirements to ensure claim accuracy and compliance.
• Maintain complete and accurate patient account documentation, including detailed account notes and follow-up activities within the billing system.
• Process incoming correspondence, payer communications, requests for information, and other account-related documentation in a timely manner.
• Generate and review reports to identify outstanding accounts, payment trends, and opportunities for process improvement.
• Respond professionally to patient inquiries and concerns regarding billing, insurance coverage, and account balances.
• Communicate effectively with patients, insurance carriers, providers, and internal departments to resolve account issues and facilitate payment.
• Adhere to HIPAA regulations, patient confidentiality standards, and organizational compliance requirements at all times.
• Participate in required education, compliance training, and professional development activities to maintain current knowledge of billing regulations and payer requirements.
• Other duties as assigned.