Patient Financial Services Cost of Care Representative

Fairview Health Services; Saint Paul (MN); On-site; USD 40,000 - 55,000; Full time

Job summary

Fairview Health Services is seeking a specialist in pre-service pricing estimates to support the Revenue Cycle Management team. This role focuses on obtaining accurate demographic and insurance information, educating patients on pricing, and generating precise estimates with attention to managed care methodologies.

The position emphasizes strong customer service, clear communication, and timely responses to inquiries.

Qualifications

• Minimum 3 years in customer service, with at least 2 years in healthcare customer service.
• Prefer an A.A./A.S. in business, healthcare, or related field.
• Experience with Epic is preferred.

Responsibilities

• Obtain required demographic, medical coding, and insurance information for accurate estimate creation.
• Provide customer-friendly education on requirements for calculating payment, pricing and scope of service.
• Generate estimates and analyze for accuracy using the estimator tool and understanding of payment methodologies.
• Provide a finalized estimate to customers with a breakdown of benefits when insured.
• Offer pre-payment options and process payments.
• Respond to inquiries professionally to resolve issues quickly and minimize impact on the customer experience.

Skills

Customer service

Education

A.A./A.S. in business or healthcare

Tools

Epic

Job description

Job Overview

Monday through Friday 7:30am -4:00pm

This position, under Revenue Cycle Management, is responsible for providing patients with timely and accurate pre-service pricing estimates with outstanding customer service. Works directly with ancillary departments, contracting, government payment and pricing staff, insurance carriers, and other internal/external resources to provide patients with appropriate payment and pricing information. Responsibilities include, but are not limited to, patient education, insurance verification, and excellent written and verbal communication.

Responsibilities

• Obtain required demographic, medical coding, and insurance information necessary for accurate estimate creation.
• Provide customer friendly education on requirements for calculating payment, pricing and scope of service that will be provided.
• Generate estimates and analyze for accuracy, using the estimator tool with an understanding of managed care payment methodologies including, but not limited to, APC, DRG, per diem, fee schedules; adjusting data to re-calculate if necessary.
• Provide a finalized estimate to customers, including a breakdown of benefits when the customer is insured.
• Offer pre-payment options to the customer when appropriate and processes payment collection.
• Respond to or escal inquiries in a professional manner in the pursuit of timely resolution and minimum impact to the customer experience.

Required Qualifications

• 3 years customer service experience with 2 of those years in healthcare customer service.

Preferred Qualifications

• A.A./A.S. in business, healthcare, or related field
• 1 year experience providing cost of care information to customers
• Experience with Epic

Benefit Overview

Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

Compensation Disclaimer

An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.

EEO Statement

EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status