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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 - Commercial Collector is responsible for ensuring timely and efficient resolution of outstanding patient accounts for CHRISTUS Health. This role works in a cooperative team environment to provide value to internal and external customers.

Key Responsibilities
  • Revenue Cycle Functions: Performs revenue cycle functions in a manner that meets or exceeds CHRISTUS Health key performance metrics.
  • Quality and Productivity Standards: Ensures PFS departmental quality and productivity standards are met.
  • Account Resolution: Collects and provides patient and payor information to facilitate account resolution.
  • Customer Communication: Responds to all types of account inquiries through written, verbal, or electronic correspondence.
  • Payor Knowledge: Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers.
  • Communication Skills: Responsible for professional and effective written and verbal communication with both internal and external customers to resolve outstanding questions for account resolution.
  • Regulatory Compliance: Compliant with all CHRISTUS Health, payer, and government regulations.
  • Coding Knowledge: Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines.
  • Documentation: Appropriately documents patient accounting host system or other systems utilized by PFS in accordance with policy and procedures.
Role-Specific ResponsibilitiesCollections
  • Collect Balances: Collects balances due from payors ensuring proper reimbursement for all services.
  • Denial Resolution: Identifies and forwards proper account denial information to the designated departmental liaison and dedicates efforts to ensure proper denial resolution and timely turnaround.
  • Collection Requirements: Maintains an active knowledge of all collection requirements by payors.
  • Collector Queue: Works collector queue daily utilizing appropriate collection system and reports.
  • Bill Forms and Filing: Demonstrates knowledge of standard bill forms and filing requirements.
  • Underpayments and Credit Balances: Identifies and resolves underpayments and credit balances with the appropriate follow-up activities within payor timely guidelines.
  • Trend Identification: Identifies and communicates trends impacting account resolution.
Requirements
  • Experience: Prefer minimum of 2 years' experience with insurance billing, collections, payment, and reimbursement verification and/or refunds.
  • Communication Skills: Professional and effective written and verbal communication required.
  • Environment: Experience working within a multi-facility hospital business office environment preferred.
  • Education: College education, previous insurance company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience.
  • UB-04 and HCFA 1500: Experience working within patient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred.