Financial Services Specialist
We are seeking an experienced and detail-oriented Financial Services Specialist to join our plastic surgery practice. This role is responsible for managing all aspects of financial billing operations including cosmetic surgery billing, out-of-network insurance claims, in-network insurance claims, follow-up, and concierge-level communication with patients. The ideal candidate will possess a deep understanding of medical billing and coding, strong analytical skills, and a commitment to delivering high customer service.
Billing & Claims Management
- Accurately process billing and claims for medical and cosmetic appointments, procedures, and surgeries while ensuring compliance with all relevant regulations and payer guidelines.
- Work closely with Northwell's managed care team to obtain single case agreements from out-of-network insurances.
- Manage out-of-network claim submissions, obtain single case agreements, track claim status, and follow up diligently to ensure timely reimbursement.
- Conduct appeals and resolve denied or underpaid claims through payer communication and documentation.
- Maintain accurate and up-to-date records in the practice management and EHR systems.
Financial Analysis & Reporting
- Perform financial assessment of patients.
- Reconcile payments with claims and address any discrepancies.
- Prepare financial reports related to insurance payments, patient balances, and outstanding claims.
- Collaborate with the surgeons and finance team to reconcile billing with accounting and financial forecasting.
Patient Financial Counseling & Concierge Service
- Provide patients with clear, compassionate guidance on financial responsibility, including estimates for cosmetic and insurance-based services.
- Offer high-level concierge communication, ensuring patients feel informed, respected, and supported throughout their financial experience.
- Respond promptly to patient inquiries regarding statements, insurance claims, and balances.
- Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Job Qualification
- Bachelor's Degree required, or equivalent combination of education and related experience.
- 3-5 years of relevant experience, required.
- Exceptional communication and interpersonal skills.
- Detail-oriented with excellent organizational and time management abilities.
- Additional Salary Detail
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