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Patient Financial Representative Senior
2 months ago
We are seeking a highly skilled and experienced Senior Patient Financial Representative to join our team at Christus Health. As a key member of our Revenue Cycle division, you will play a critical role in ensuring the timely and efficient resolution of patient accounts.
Key Responsibilities- Perform Revenue Cycle functions in a manner that meets or exceeds Christus Health's key performance metrics.
- Ensure PFS departmental quality and productivity standards are met.
- Collect and provide patient and payor information to facilitate account resolution.
- Respond to all types of account inquiries through written, verbal, or electronic correspondence.
- Maintain payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers.
- Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution.
- Meet or exceed customer expectations and requirements, and gain customer trust and respect.
- Compliant with all Christus Health, payer, and government regulations.
- Exhibit a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
- Appropriately document patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
- Provide continuous updates and information to the PFS Leadership Team regarding errors, issues, and trends related to activities affecting productivity, reimbursement, payment delays, and/or patient experience.
- Review and work on claim edits.
- Work payor rejected claims for resubmission.
- Work reports and billing requests.
- Demonstrate strong knowledge of standard bill forms and filing requirements.
- Exhibit and understanding of electronic claims editing and submission capabilities.
- Collect balances due from payors ensuring proper reimbursement for all services.
- Identify and forward proper account denial information to the designated departmental liaison.
- Maintain an active knowledge of all collection requirements by payors.
- Work collector queue daily utilizing appropriate collection system and reports.
- Demonstrate knowledge of standard bill forms and filing requirements.
- Identify and resolve underpayments with the appropriate follow-up activities within payor timely guidelines.
- Identify and resolve credit balances with the appropriate follow-up activities within payor timely guidelines.
- Identify and communicate trends impacting account resolution.
- Ensure all payments are retrieved and posted accurately and timely through reconciliation of patient accounting system and bank statement.
- Research submitted cash payments by verifying patient account numbers and appropriate facilities.
- Monitor and perform cash reconciliation to identify cash posting errors and ensures all receipts are applied and reconciles to daily bank deposit and monthly bank statements.
- Review and post cash corrections, including resolving patient complaints and inquiries from PFS, Finance, Facilities, and Vendor Partners.
- Resolve and Research unapplied cash, including continuous follow-up until payment identification is made for application of payment or refund.
- HS Diploma or equivalent years of experience required.
- Post HS education preferred.
- 3-5 years of experience preferred.
- Experience working within a multi-facility hospital business office environment preferred.
- College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
- Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred.
