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Patient Financial Representative Senior

2 months ago


Irving, Texas, United States Christus Health Full time

Job Summary:

The Patient Financial Representative Senior is responsible for ensuring account resolution and reconciliation of outstanding balances for Christus Health patient accounts. This role works in a cooperative team environment to provide value to internal and external customers.

Key Responsibilities:

  • Meet expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
  • 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.
  • Must have professional and effective written and verbal communication.
  • Billing
  • 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 an understanding of electronic claims editing and submission capabilities.
  • Collections
  • 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.
  • Cash Reconciliation
  • 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.

Requirements:

Education/Skills

  • HS Diploma or equivalent years of experience required.
  • Post HS education preferred.

Experience

  • 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.

Licenses, Registrations, or Certifications

  • None required.

Work Schedule:

TBD

Work Type:

Full Time

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