Purpose of the Role
Client Partners supporting the Self-Pay Program are responsible for delivering high-quality patient financial services through effective communication, accurate processing, and strict adherence to client-approved policies and workflows. This role requires strong customer service, attention to detail, and compliance discipline to ensure seamless patient experience while meeting client performance expectations.
Description of Services
- In-Scope Responsibilities: Client Partners are expected to perform the following core functions within the Self-Pay Program:
- Patient Financial Interactions
- Conduct inbound and outbound patient collections using approved scripts, call flows, and established policies.
- Demonstrate knowledge to address patient questions on balances, payment plans, and insurance coverage.
- Process patient payments within the client system and post transactions accurately to patient ledgers.
- Reprocess declined payments.
- Account Management
- Process insurance balance transfers and manual write-offs as required.
- Perform ledger modifications for pre-due date payments resulting in account credits.
- Manage and rework patient accounts, including adjustments to payment plans, updating insurance information, and processing demographic changes.
- Patient Support Services
- Triage patient inquiries and route to appropriate departments.
- Handle requests for itemized statements.
- Support financial assistance applications and provide relevant guidance.
- Manage patient disputes through established resolution processes.
- Out-of-Scope Services: The following functions are not part of the Self-Pay Program scope:
- Credit reporting activities.
- Collection calls beyond patient financial engagement.
Key Competencies Required
- Strong verbal and written communication skills.
- Working knowledge of healthcare billing, insurance, and patient payment processes.
- Ability to navigate Client systems with accuracy and efficiency.
- High level of integrity, confidentiality, and compliance adherence.
- Problem-solving and conflict resolution skills for handling patient disputes.
Performance Expectations
- Adherence to quality and compliance standards as defined by the Client.
- Client Partner is expected to demonstrate a clear understanding of how to interpret an Explanation of Benefits (EOB).
- Achievement of patient engagement and resolution targets.
- Consistent documentation of all patient interactions.
- Contribution to a positive and professional patient experience.
