Financial Administrative Representative

Job Summary:

The Emergency Financial Representative is responsible for securing reimbursement from patients and responsible parties by verifying insurance coverage, determining eligibility, and facilitating point-of-service collections. This role involves assisting patients in understanding their healthcare insurance benefits, setting up financial arrangements to prevent bad debt, and guiding patients through programs such as Medi-Cal, Uncompensated Care, and Hospital Presumptive Eligibility. The representative works closely with patients after medical screening, ensuring accurate registration and financial counseling to support hospital revenue and patient access to care.

Responsibilities:

• Verify patient insurance eligibility, benefits, and utilization requirements.
• Collect point-of-service payments and establish payment arrangements with patients.
• Assist patients in accessing financial assistance programs including Medi-Cal, Uncompensated Care, and Hospital Presumptive Eligibility.
• Perform accurate patient registration and financial counseling to expedite approvals before discharge.
• Maintain compliance with privacy policies and HIPAA Security and Privacy Rules.
• Communicate effectively with patients, healthcare providers, insurance companies, and vendors.
• Document and follow up on patient accounts and financial arrangements to ensure reimbursement.
• Complete required training and certification programs related to financial eligibility and assistance.
• Operate computer systems including EPIC EHR and MS Office with proficiency.
• Adhere to hospital policies and government regulations regarding patient financial services.

Required Skills & Certifications:

• Minimum High School Diploma or GED.
• At least 2 years of experience in front office, medical billing, hospital registration/admitting, insurance verification, or medical/hospital billing.
• Proficiency with EPIC Electronic Health Record system.
• Strong mathematical skills including ability to calculate copays and financial estimates accurately.
• Excellent English reading, writing, and communication skills.
• Strong computer skills including typing speed of 45+ wpm and proficiency in MS Office programs.
• Knowledge of government healthcare programs such as Medi-Cal, Medicare, Covered California, COBRA, and uncompensated care.
• Understanding of EMTALA regulations.
• Ability to maintain confidentiality and comply with HIPAA regulations.

Preferred Skills & Certifications:

• Evidence of continuing education in Finance, Accounting, or Business Administration.
• Bilingual language skills.
• Experience with IPA (Independent Practice Association) knowledge.
• Prior experience working directly with insurance companies and high liability accounts.

Special Considerations:

• Position requires adherence to strict privacy and security policies.
• Ability to work under pressure in a fast-paced environment.
• Must exercise independent judgment in emergency or urgent situations.
• Interaction with patients occurs only after medical screening exam is completed.
• Rotating weekends and holidays are required.

Scheduling:

• Part-time schedule from 11:30 AM to 8:00 PM.
• Minimum guaranteed 56 hours every two weeks.
• Rotating weekends and holiday shifts are part of the schedule.