Utilization Financial Specialist

Community Healthcore; Longview (TX); On-site; USD 32,000 - 42,000; Full time

Job summary

Community Healthcore in Longview, TX is hiring a Patient Financial Services Clerk to determine and collect patients' financial responsibility at the time of service. The role includes screening for third-party payer resources and verifying outpatient psychiatric benefits to ensure accuracy in the clinical database.

The position requires strong customer service, data entry, and communication skills, plus the ability to manage multiple tasks and work as part of a quality improvement team.

Qualifications

• High School Diploma / GED required; business practices training preferred.
• Minimum 1 year of customer service experience with the public.
• Experience in healthcare setting preferred.
• Ability to perform basic mathematical calculations for accounts.
• Speed and accuracy in computer data entry.
• Strong organizational and multitasking abilities.
• Excellent interview and communication skills.
• Team player with quality improvement mindset.

Responsibilities

• Determine and collect patients' financial responsibility at service time.
• Screen for available third-party payer resources and verify benefits.
• Maintain accuracy of patient demographics and financial data.
• Oversee patient accounts and assist in reconciling balances.
• Monitor payer requirements and ensure compliance before next appointment.
• Support continuous quality improvement activities.

Skills

Customer service

Healthcare setting

Data entry

Organizational skills

Interviews & communication

Problem solving

Education

High School Diploma / GED

Job description

Responsible for determining and collecting patients' financial responsibility at the time of service. Screens for available third party payer resources. Researches identified resources to determine and/or verify outpatient psychiatric benefits. Accountable for the accuracy of patient demographic and financial information recorded in the center clinical database. Responsible for oversight of patient accounts and provides assistance to reconcile patient account balances. Monitors financial and/or clinical data for individual payer requirements compliance. Ensures that all non-compliance issues are resolved prior to, or at the time of, the patients' next scheduled appointment. Maintains working knowledge of psychiatric procedures/services as necessary to monitor the accuracy of recorded versus scheduled procedures. Responsible for oversight of patient accounts, provides assistance and counseling aid in resolving patient account balances.

Education/licensure:

High School Diploma / GED Equivalent required; additional training / education in business practices preferred.

Current valid driver's license in state of residence.

Experience/Knowledge:

Minimum of 1 year customer service related experience working with the general public

Previous experience working in a healthcare setting preferred

Ability to perform basic mathematical calculations as necessary to oversee patient account and receipts required

Computer data entry experience/emphasizing speed and accuracy.

Requires advanced organizational skills and ability to manage multiple tasks.

Requires advanced interview and communication skills.

Functions as a team member and actively participates in continuous quality improvement activities.

Demonstrates aptitude for logical and deliberate problem solving and decision making

Physical requirements that are bona fide occupational qualifications essential to the performance of the job:

Moderate lifting and carrying up to a maximum of 20 pounds

Sitting for prolonged periods, walking, bending, stooping, kneeling and reaching above shoulder height

Motor skills necessary to operate essential office equipment