Employment Type:

Full time

Shift:

Day Shift

Description:

The Patient Financial Specialist III performs all the functions of a PFS II. In addition, the PFS III performs verification of prior authorization and obtaining precertification for selected scheduled services. Also, this staff member is proficient in scheduling complex procedures from the physician’s office as well as complex and changing insurance/reimbursement requirements.

Location: Mount Carmel East

Unit: Radiation Oncology

Shift: Monday - Friday 7:30am - 4:00pm

Responsibilities   

• Performs activities that relate to patient scheduling, pre-registration, real-time eligibility verification, insurance authorization, medical order processing, medical necessity review (LMRP/LCD review), dissemination of patient information, and support coverage of other intra-departmental functions.
• Determines proper scheduling requirements and/or limitations according to requested test(s)/procedure(s) and schedules resources (equipment, staff, room, and etc.) in a timely manner to ensure customer satisfaction, maintain patient flow, and appropriate utilization of the service area. Coordinates add-on and same-day appointments with the service area, as required. Ensures proper test sequencing with minimal patient delays when multiple testing is required.
• Provides patient, family and physician office education during scheduling process to inform them of preparations needed for diagnostic testing and proper scheduling instructions. Communicates with various ancillary departments to ensure an accurate schedule and that all reports are properly distributed.
• Validates medical necessity (LMRP/LCD review) of Medicare and Non-Medicare cases to ensure clinical and financial clearance. Contacts physicians/office staff for clarification, if cases require clarification of diagnosis and/or test(s)/procedure(s).

Requirements/Qualifications

• High School Diploma
• Working knowledge of medical terminology, and data entry skills. Past work experience of at least two (4) years within a physician office, hospital or clinic environment, performing patient scheduling and precertification activities is highly desired 
• Proven experience in 2 of the 4 following areas: Web and fax orders, Outpatient IV scheduling, Complex physician office scheduling such as Wound care and physician performed procedures, or Precertification.
• Excellent interpersonal skills are necessary in dealing with peers, internal, and external customers. Accuracy, attentiveness to detail and time management skills are required.

Position Highlights and Benefits:

• Mount Carmel Health System recognized by Forbes in 2025 as one of America’s Best State Employers.
• Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
• Retirement savings account with employer match starting on day one.
• Generous paid time off programs.
• Employee recognition programs.
• Tuition/professional development reimbursement starting on day one.
• RN to BSN tuition 100% paid at Mount Carmel’s College of Nursing.
• Relocation assistance (geographic and position restrictions apply).
• Employee Referral Rewards program.
• Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!
• Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.

Ministry/Facility Information:

Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you’re seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.