Patient Financial Services Rep - hybrid role

The Patient Financial Services Representative (PFSR) supports Mountain Community Health’s (MCH) mission by helping patients navigate the financial aspects of their care with accuracy, empathy, and professionalism. This position bridges front-end eligibility and back-end billing functions by verifying coverage, assisting patients with insurance and sliding-fee applications, establishing payment plans, and maintaining accurate accounts receivable records. The PFSR works closely with the Revenue Cycle Manager, front desk staff, and finance team to ensure timely, compliant, and patient-centered billing practices for MCH as a Federally Qualified Health Center (FQHC).  Ability for hybrid schedule will be considered after 90 days.

Patient Financial Services & Accounts Receivable Duties:

• Provide clear, compassionate communication with patients regarding billing statements and account balances.
• Review outstanding balances, explain insurance payments, and collect co-pays, deductibles, and self-pay amounts.
• Establish and document patient payment arrangements consistent with MCH Billing and Collections Policy.
• Perform timely follow-up on overdue accounts to include but not limited to monthly collection calls.
• Manage self-pay and self-pay-after-insurance accounts receivable; utilize aging reports to prioritize outreach.
• Document all communications, payment plans, and follow-up activity in the EMR.
• Collaborate with the Revenue Cycle Manager on account adjustments, write-offs, and bad-debt transfers.
• Maintain accurate daily cash, credit-card, and check reconciliation logs; support finance with deposit verification.
• Support month-end reporting and assist with audit readiness as directed.

• Verify patient insurance eligibility as needed to support front desk staff and reduce claim denials.
• Educate patients about insurance benefits, cost-sharing, and available financial assistance.
• Assist patients with Medicaid, Vermont Health Connect, and MCH Sliding Fee Discount Program applications.
• Collect and verify required documentation for financial assistance programs; maintain accurate records.
• Counsel patients on payment options and ensure understanding of their financial responsibility prior to or after service.

• Partner with the Revenue Cycle Manager to identify trends in patient billing or denial patterns and provide cross-coverage support during absences or periods of high volume.
• Coordinate with front-office and clinical teams to correct demographic or insurance data errors.
• Participate in staff training on eligibility and patient-payment processes.
• Cross-train to provide limited coverage for billing and front desk functions as needed.
• Contribute to process improvement initiatives to enhance efficiency, compliance, and patient satisfaction.

• Maintain confidentiality of patient and financial information in accordance with HIPAA.

• High school diploma or equivalent; education in business, healthcare administration, or related field preferred. 
• Equivalent of one-year experience in patient accounts, healthcare finance, and customer service.
• Experience in FQHC, community health center, or other multi-payer medical environments preferred.
• Experience with ICD-10 and CPT codes preferred. 
• Strong customer-service and interpersonal communication skills.
• Knowledge of medical insurance plans, eligibility, and coordination of benefits.
• Understanding of payment posting, patient statements, and account reconciliation.
• Proficiency in practice-management and electronic health record (EHR/EMR) systems preferred.
• Successful completion of Vermont Health Connect Assister Certification or ability to complete the course within six months of hire (company paid)
• Intermediate computer skills (Word, Excel, Outlook) and ability to manage multiple tasks efficiently.
• Critical thinking, problem-solving, and attention to detail.
• Commitment to confidentiality, teamwork, and MCH’s mission and values. 
• Maintain confidentiality of patient and financial information in accordance with HIPAA.