Senior Patient Financial Specialist
2 weeks ago
Overview:
The individual in this role is tasked with providing essential support to the Revenue Cycle division at CHRISTUS Health. This position is pivotal in ensuring timely and efficient management of patient accounts, focusing on resolving outstanding balances and reconciling accounts. The role thrives in a collaborative team atmosphere, aiming to deliver exceptional service to both internal and external stakeholders.
The associate upholds the highest ethical standards and acts in alignment with the mission, philosophy, and core values of CHRISTUS Health, which include Dignity, Integrity, Compassion, Excellence, and Stewardship.
Key Responsibilities:
- Exemplifies the OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- Conducts Revenue Cycle operations that meet or surpass CHRISTUS Health's performance metrics.
- Ensures adherence to departmental quality and productivity benchmarks.
- Gathers and shares 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 and regulations for third-party payers, along with a solid understanding of all Revenue Cycle functions.
- Communicates professionally and effectively with both internal and external clients to resolve inquiries related to account resolution.
- Strives to meet or exceed customer expectations, fostering trust and respect.
- Adheres to all regulations set forth by CHRISTUS Health, payers, and government entities.
- Demonstrates a thorough 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 impact productivity, reimbursement, payment delays, and patient experience.
- Exhibits strong written and verbal communication skills.
Billing Responsibilities:
- Reviews and processes claim edits.
- Handles payer-rejected claims for resubmission.
- Manages reports and billing requests.
- Demonstrates expertise in standard billing forms and filing requirements.
- Understands electronic claims editing and submission processes.
Collections Duties:
- Collects outstanding balances from payers to ensure proper reimbursement for services rendered.
- Identifies and forwards account denial information to the appropriate departmental liaison, focusing on timely resolution.
- Maintains current knowledge of all collection requirements by payers.
- Utilizes the collector queue daily, employing the appropriate collection systems and reports.
- Recognizes and resolves underpayments in accordance with payer guidelines.
- Identifies and addresses credit balances through timely follow-up activities.
- Communicates trends that affect account resolution.
Cash Reconciliation Tasks:
- Ensures accurate and timely posting of all payments through reconciliation of the patient accounting system and bank statements.
- Researches cash payments by verifying patient account numbers and facilities.
- Monitors cash reconciliation processes to identify posting errors and ensures all receipts are applied correctly.
- Reviews and posts cash corrections, addressing patient complaints and inquiries from various departments.
- Investigates unapplied cash, ensuring continuous follow-up until payment identification is achieved.
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 is advantageous.
- College education, previous insurance claims experience, or health care billing training may be considered in lieu of formal hospital experience.
- Familiarity with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 forms is preferred.
Work Type:
Full Time
EEO is the law -
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