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Senior Patient Financial Specialist
2 months ago
Overview:
The Senior Patient Financial Representative plays a crucial role in supporting the Revenue Cycle department at CHRISTUS Health. This position is dedicated to ensuring timely and efficient processes that facilitate account resolution and the reconciliation of outstanding balances for patient accounts. The representative collaborates within a team environment to deliver exceptional service to both internal and external stakeholders.
The individual upholds the highest standards of ethical conduct, prioritizing the interests of CHRISTUS Health while embodying the organization's Mission, Philosophy, and core values of Dignity, Integrity, Compassion, Excellence, and Stewardship.
Key Responsibilities:
• Adheres to the OneCHRISTUS Competencies, demonstrating leadership in self-management and team collaboration.
• Executes Revenue Cycle tasks that meet or surpass the performance metrics established by CHRISTUS Health.
• Ensures compliance with departmental quality and productivity benchmarks.
• Gathers and provides essential patient and payer information to aid in account resolution.
• Addresses various account inquiries through written, verbal, or electronic communication.
• Maintains comprehensive knowledge of insurance and self-pay billing guidelines, as well as regulations for third-party payers, while being familiar with all functions within the Revenue Cycle.
• Communicates professionally and effectively with both internal and external customers to resolve outstanding account questions.
• Strives to meet or exceed customer expectations, fostering trust and respect.
• Complies with all relevant CHRISTUS Health, payer, and governmental regulations.
• Demonstrates a solid understanding of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
• Accurately documents activities in the patient accounting system in accordance with established policies and procedures.
• Provides ongoing updates to the PFS Leadership Team regarding errors, issues, and trends that may impact productivity, reimbursement, payment delays, or patient experience.
• Exhibits strong written and verbal communication skills.
Billing Duties
• Reviews and addresses claim edits.
• Manages payer-rejected claims for resubmission.
• Processes reports and billing requests.
• Displays a thorough understanding of standard billing forms and submission requirements.
• Understands electronic claims editing and submission processes.
Collections Responsibilities
• Collects outstanding balances from payers, ensuring proper reimbursement for services rendered.
• Identifies and forwards denial information to the appropriate departmental liaison, focusing on timely resolution.
• Maintains up-to-date knowledge of collection requirements from various payers.
• Utilizes the collector queue daily, employing the appropriate collection systems and reports.
• Demonstrates knowledge of standard billing forms and filing requirements.
• Identifies and resolves underpayments and credit balances, ensuring timely follow-up activities.
• Communicates trends affecting account resolution.
Cash Reconciliation Duties
• Ensures accurate and timely posting of all payments through reconciliation of the patient accounting system and bank statements.
• Verifies patient account numbers and facilities for submitted cash payments.
• Monitors cash reconciliation processes to identify posting errors and ensures all receipts align with daily deposits and monthly statements.
• Reviews and posts cash corrections, addressing patient inquiries and complaints as necessary.
• Resolves unapplied cash issues, maintaining follow-up until payments are identified for application or refund.
Qualifications:
- High School Diploma or equivalent experience required.
- Post-secondary education preferred.
- 3-5 years of relevant experience preferred.
- Experience in a multi-facility hospital business office environment preferred.
- College education, previous insurance claims experience, or health care billing trade school education may be considered in lieu of formal hospital experience.
- Familiarity with patient and outpatient billing requirements of UB-04 and HCFA 1500 forms preferred.
Work Schedule:
TBD
Work Type:
Full Time
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